Childhood Neuroblastoma
Neuroblastoma is a tumor that develops from the nerve cells. It is the most common form of infant cancer, usually occuring in children under the age of five, and the fourth most common type of cancer in children.
About two-thirds of all neuroblastomas start in the abdomen, developing in the nerve tissue of the adrenal glands (above the kidneys). They also occur in the neck, chest or spinal cord. Sometimes the tumor begins forming before birth, and in rare cases a prenatal diagnosis can be made using ultrasound.
Infants with neuroblastoma under one year of age have a better prognosis than older children, regardless of the extent of the disease. Some neuroblastomas disappear in infants without any neurobalstoma treatment at all. Watchful waiting may be an option for some infants meeting certain diagnostic criteria. It is important for your child to receive an accurate diagnosis and obtain treatment in a highly specialized environment from a team of doctors with expertise in neuroblastoma treatment.
Patient Education
- Neuroblastoma I Espanol (pdf)
Symptoms
Neuroblastoma may have no symptoms at all, or symptoms that may resemble common illnesses. These symptoms may include diarrhea, bruising, loss of appetite, tiredness, and bone pain, and will vary depending on the location of the original tumor and the extent of metastases to other parts of the body. Other symptoms include:
- Lumps in the abdomen, lower back, neck or chest
- Bone pain (caused by spread of cancer to the bone)
- Bulging eyes
- Dark circles under or around the eyes
- Swollen, distended stomach
- Breathing problems
- Difficulty swallowing
- Weakness or paralysis of the lower extremities
- Fever, anemia and high blood pressure are found occasionally
Tests & Procedures
Neuroblastoma can be difficult to diagnose. Unfortunately, many patients have widespread disease at the time of diagnosis. The cancer most commonly metastasizes (spreads) to the lymph nodes, liver, bones and bone marrow.
Tests to diagnose and evaluate children with neuroblastoma, including MRI or CT scans, bone scans, MIBG scans, ultrasound, bone marrow tests and urine and blood tests are used to find the precise location of the tumor and to see whether it has spread. A biopsy provides a conclusive diagnosis.
Treatment
The treatment of neuroblastoma is based on the child’s age; the size, location and biologic features of the tumor; and whether the cancer has spread. Generally, treatments include chemotherapy, surgery, and/or radiation therapy. Combinations of two or three of these treatments may be used for some children.
Other types of treatments are being tested in clinical trials. Some children will require a combination of treatments, including intensive chemotherapy and a bone marrow transplant.
If the cancer continues to grow during treatment, it is called progressive neuroblastoma. Recurrent neuroblastoma is when the cancer comes back after treatment, either to the same or different location. The Children’s Cancer Hospital has many new treatment trials available and in development for the specific treatment of progressive and recurrent neuroblastomas.
Clinical Trials
The most innovative treatments for childhood central nervous system tumors are offered as part of clinical trials, which are closely monitored studies to test the safety and effectiveness of new treatments. Go to M. D. Anderson's list of current pediatric clinical trials to see if your child might be eligible.
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