Neuroblastoma

Neuroblastoma is a rare but serious pediatric cancer that develops from immature nerve cells called neuroblasts, which are part of the sympathetic nervous system. It most commonly affects infants and young children, typically arising in the adrenal glands above the kidneys, though it can also occur in the chest, abdomen, neck, or spine. The exact cause is largely unknown, but genetic factors play a role in a small proportion of cases.

Clinical presentation varies widely. Some children develop a painless abdominal mass, while others may experience bone pain, fatigue, weight loss, fever, or neurological symptoms due to tumor spread or spinal cord compression. Diagnosis involves imaging studies, blood and urine tests for tumor markers, biopsy, and bone marrow evaluation. Staging and risk classification are critical in guiding treatment decisions.

Treatment of neuroblastoma is highly risk-adapted. Low-risk cases may require minimal therapy or observation, while high-risk disease demands intensive multimodal treatment, including chemotherapy, surgery, radiation therapy, stem cell transplantation, immunotherapy, and differentiation therapy. Advances in biologic understanding and immunotherapeutic approaches have improved survival outcomes. Long-term follow-up is essential to monitor for relapse and manage potential late effects, supporting overall growth, development, and quality of life.