Neuroblastoma in children

Written by Gao Yi Shen
Neurosurgery
Updated on January 12, 2025
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Neuroblastoma does not specifically concern how old the child is, as it can occur in children during their developmental process, and even in newborns, adolescents, and adults. There is no specific timing required for its occurrence. Therefore, for neuroblastoma, the principle is to initiate treatment as soon as it is detected. Although the prognosis may not be very good, the aim should be to extend the patient's life and reduce suffering as much as possible. After all, no matter the age, the patient is a loved one.

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How is neuroblastoma diagnosed?

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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How to diagnose neuroblastoma?

For neuroblastoma, the final diagnosis requires the patient to undergo surgical treatment. During the surgery, the neuroblastoma is completely excised, and a small amount of tumor tissue is retained for pathological sectioning. The diagnosis is determined based on the results of the pathological examination, which assesses the specific cells of the neuroblastoma, whether it is benign or malignant, and its level of malignancy. This also determines how the patient will receive subsequent treatments like radiotherapy and chemotherapy. In addition to relying on pathological examinations, most neuroblastoma patients can also undergo more thorough examinations. In most cases, elevated levels of catecholamines and their metabolites can be found in the blood or urine of neuroblastoma patients, significantly higher than that of the normal population.

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Symptoms of neuroblastoma recurrence

For neuroblastoma, when the tumor recurs, the patient's original symptoms such as headaches, dizziness, nausea, and vomiting will reappear, occurring intermittently and worsening persistently. Most patients will experience significant increased intracranial pressure, and even frequent nausea and vomiting. Additionally, some neuroblastoma patients experience severe vertigo, especially when changing body positions, where the vertigo is particularly pronounced. For such patients, when the above symptoms and signs occur, they should go to a local hospital as soon as possible for a reassessment using cranial MRI to monitor changes in their condition.

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Written by Chen Yu Fei
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Is neuroblastoma serious?

Neuroblastoma is relatively serious and is classified as a highly malignant tumor, one of the epithelial cell tumors. The disease often leads to severe intracranial pressure increases, manifesting as intense headaches, dizziness, nausea, vomiting, and even possible optic disc edema, vision loss, and visual field defects. The occurrence of neuroblastoma often indicates a poor prognosis for patients, with a short disease duration and reduced survival time. The five-year survival rate is decreased. Treatment primarily involves surgical intervention to completely remove the neuroblastoma, followed by postoperative radiotherapy, chemotherapy, and other related treatments.

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Written by Chen Yu Fei
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How to check for neuroblastoma?

For the examination of neuroblastoma, we generally recommend a neurological examination to help determine whether there are any clear positive signs, as well as to inquire about medical history and family history to judge if there are any cases of neuroblastoma among family members. Additionally, detailed laboratory tests, routine blood tests, routine urine tests, and biochemical tests, including tumor-related diagnostics, can help in making assessments. Of course, the most accurate and crucial examinations are CT or MRI scans of the head. If necessary, an enhanced MRI scan of the head can be conducted to further evaluate the location, nature, severity of the tumor, and its relationship with the surrounding neural and vascular tissues, which helps provide a basis for further surgical treatment.