Ver el código de «Neuroblastoma (peds)»

==Background==
[[File:PMC4112030 40064 2013 1059 Fig3 HTML.png|thumb|Neuroblastoma: (a) Abdominal CT-scan: large heterogeneous right abdominal mass with a tumor thrombus of the inferior vena (Arrow). (b) Gross examination of the tumor: heterogeneous partially necrotizing tumor of the right adrenal gland. (c):Histology of the tumor: neuroblastoma poorly differentiated.]]
*Arises from primitive ganglion cells of sympathetic nervous system
*Synthesize and secrete catecholamines
*Most common neoplasm in 1st yr of life
*May arise anywhere along sympathetic nervous system
**Adrenal gland (40%)
**Abdomen (25%)
**Chest (15%)
*Mets are most common in lymph nodes, bone marrow, cortical bone, dura, orbits, liver, and skin

==Clinical Features==
*Depends on location
**Abdominal mass
***2/3 of primary neuroblastoma arise in the abdomen<ref>https://www.uptodate.com/contents/clinical-presentation-diagnosis-and-staging-evaluation-of-neuroblastoma?search=neuroblastoma%20children&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1</ref>
**Abdominal pain or constipation
**Proptosis or periorbital ecchymoses
**[[Horner syndrome]]: miosis, ptosis, anhidrosis
**Paraspinal mass
**Spinal cord compression, which can cause localized back pain or weakness
**Systemic symptoms, bone pain, anemia
*[[Opsoclonus]]-myoclonus: rapid, dancing eye movements, rhythmic jerking of trunk or limbs, and/or ataxia
**[[paraneoplastic]] syndrome highly associated with neuroblastoma
*[[Neutropenia]]/[[pancytopenia]] suggests bone marrow involvement

==Differential Diagnosis==
*[[Wilms' tumor]]
*Hepatoblastoma
*Lymphoma 
*Other adrenal gland tumor

==Evaluation==
[[File:PMC4769609 gr2.png|thumb|Abdominal CT demonstrating (A) a heterogeneously enhancing mass in the pancreatic body and tail with (B) encasement of the celiac axis.]]
[[File:PMC4206056 jrip-3-79-g001.png|thumb|Neuroblastoma accompanied by hyperaldosteronism.]]
*Catecholamines; VMA and HVA of serum and urine
*CT or MRI
**Although US is often the initial radiologic study of choice for abdominal mass, primary tumor site and possible nodes on are better evaluated on CT or MRI
*[[CXR]]
*Biopsy for definitive diagnosis

==Management==
*No acute treatment

==Disposition==
*Admission for tumor biopsy and further workup

==See Also==

==External Links==

==References==
<references/>
[[Category:Pediatrics]]
[[Category:Heme/Onc]]