How is neuroblastoma diagnosed?

Written by Chen Yu Fei
Neurosurgery
Updated on September 05, 2024
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For patients with neuroblastoma, diagnosis is primarily through the symptoms, signs, detailed physical examinations, medical history inquiries, and most importantly, radiological data, which includes CT scans or MRI of the head. Definitive diagnosis requires surgical removal of the tumor. A small amount of tumor tissue is retained after excision and used for pathological examination to confirm the diagnosis. Neuroblastoma is categorized as an epithelial-like malignant tumor, indicative of a high degree of malignancy. In most cases, early in the disease, the tumor adheres to surrounding tissues, which greatly complicates complete surgical removal, and most patients have a poor prognosis.

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Neurosurgery
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Causes of Neuroblastoma

Currently, there is no definitive conclusion about the specific causes of neuroblastoma, but most scholars believe that the occurrence of neuroblastoma is the result of congenital genetic factors combined with acquired factors. For patients with neuroblastoma, there is often a family history of genetic diseases showing a familial clustering tendency. In addition, poor living environments and habits, including exposure to radioactive contamination or prolonged exposure to electromagnetic radiation, may also contribute to the development of neuroblastoma.

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Neuroblastoma ultrasound manifestations

Regarding the ultrasonic manifestations of neuroblastoma, they typically occur at the site of the neuroblastoma. Some neuroblastomas occur in the retroperitoneal space, such as near the adrenal glands or alongside the spine, usually presenting direct and indirect signs. Direct signs often manifest as a large tumor volume, often crossing the midline, characterized internally primarily by hypoechoic areas with significant returns unevenness, and rich blood flow around the tumor. Some patients may exhibit tumor calcification, which can cause encasement or invasion of major retroperitoneal vessels, but less commonly invasion resulting in acid efflux. Indirect signs mainly include causing renal hydronephrosis, potentially leading to enlargement of surrounding lymph nodes, and causing ascites.

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Precursors to neuroblastoma recurrence

For neuroblastoma, if recurrence occurs, the patient may show symptoms like recurrent headaches, dizziness, nausea, and vomiting. Additionally, if the optic nerve is involved, there may be a decrease in vision and visual field defects. Even the possibility exists that the tumor could recur, increase in size, and compress surrounding important blood vessels and nerves, leading to an increase in intracranial pressure, which manifests as worsening of the original symptoms of headaches and dizziness. Once such symptoms occur, it generally suggests a high likelihood of neuroblastoma recurrence. If it causes symptoms such as hemiplegia and aphasia, it can generally be confirmed.

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Late-stage symptoms of neuroblastoma

For patients with neuroblastoma, they often experience significant symptoms such as headaches, dizziness, nausea, and vomiting. The intracranial pressure continuously rises, leading to noticeable optic atrophy, vision loss, and visual field defects. When the tumor volume further increases, it may also compress the surrounding tissues, causing apparent cranial nerve dysfunction. Moreover, in the late stages of the disease, the tumor can spread to other parts of the body via the bloodstream, forming metastases. Additionally, it is likely to disseminate through the cerebrospinal fluid.

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Symptoms of Neuroblastoma

Typical symptoms of neuroblastoma include anemia and fatigue, excitement, no weight gain or weight loss, or irregular fever. The initial symptoms in the course of a short disease are not typical. Early diagnosis is difficult. Nonspecific symptoms include fatigue, loss of appetite, fever, joint pain. Those occurring within the skull display a bit of central nervous system cursing symptoms and symptoms of intracranial hypertension. Main manifestation. Occurrence outside the skull depends on the location of the tumor and the metastatic sites. Involvement of the thoracic cavity can cause chest and back pain and difficulty breathing, involvement of the abdominal cavity is characterized by abdominal distension, constipation, dysentery, and involvement of the spinal canal manifests as reduced strength in the trunk and limbs, and motor and sensory disturbances.