Neuroblastoma

Neuroblastoma is another highly malignant tumour which mostly occurs in infants; about 80 per cent occur in children under five. It arises from remains of embryonic tissue mostly in the abdomen and invades surrounding tissues and distant organs. The first symptom is usually an abdominal swelling or excessive sweating due to the secretion of special hormones called catecholamines.

Diagnosis

The diagnosis is usually made by an X-ray which reveals an abdominal mass with calcifications, possibly in conjunction with breakdown products of catecholamines in the child’s urine.

Age is an important factor in prognosis. At birth an infant with neuroblastoma has almost a 100 per cent chance of being cured; over the age of one that chance drops to 50 per cent and a child older than two probably only has a 20 per cent chance of cure. The reason for this age dependence is the lower malignancy of the tumour in a small baby which usually is localised and can he removed.

Treatment

Neuroblastoma is much harder to cure than Wilms’ tumour because it is usually very widespread on discovery and is not so responsive to chemotherapy The over all cure rate is about 30 per cent, with young children doing best. One intriguing feature about neuroblastoma in the very young is its tendency to spontaneous regression, even when it is quite widespread.