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According to the American Cancer Society, about 700 cases of neuroblastoma are diagnosed each year in the United States. This accounts for about 7% of pediatric cancers.
The most common cancer in infants, neuroblastoma is the fourth most common in all children. It almost always develops before age 5, and the average age of diagnosis is between 1 and 2 years. Occasionally, it can be seen in an ultrasound before a baby is born.
Most neuroblastomas develop in the adrenal glands, abdomen or nerve cells next to the spinal cord, called ganglia. They also can occur in the neck, chest or spine.
Some neuroblastomas grow quickly; others grow slowly. When neuroblastoma develops in infancy, it often is less aggressive and can even become benign. In children over 18 months, it tends to be more dangerous.
If neuroblastoma grows in the process of treatment, it is called progressive neuroblastoma. If it comes back after treatment, it is called recurrent neuroblastoma. The pediatric cancer specialists at Children’s Cancer Hospital have an exceptional level of expertise in treating all forms of neuroblastoma.
In rare cases, neuroblastoma can be passed down from one generation to the next. Genetic counseling may be right for you. Visit our genetic testing page to learn more.
Sometimes neuroblastoma has no symptoms, and sometimes it is misdiagnosed because its symptoms look like those of other, more common conditions.
Signs of neuroblastoma depend upon where the tumor is, its size, whether the cancer has spread and if it is making hormones. Symptoms may include:
- Loss of appetite, weight loss
- Lumps in the abdomen, lower back, neck or chest
- Bone pain (caused by spread of cancer to the bone)
- Bulging eyes, drooping eyelid
- Dark circles under or around the eyes
- Swollen, distended stomach
- Breathing problems or coughing
- Difficulty swallowing
- Weakness or paralysis of the lower extremities
- Fever, anemia and high blood pressure
- Swelling of legs or scrotum
- Problems with urination or bowel movements
- Headaches, dizziness
Most children with these symptoms do not have neuroblastoma. Usually they are caused by other, less serious conditions. However, it’s a good idea to talk to your child’s doctor to rule out any health concerns.
Neuroblastoma can be difficult to diagnose. The highly specialized experts at MD Anderson Children’s Cancer Hospital have a deep level of experience and the most advanced technology to pinpoint the disease. This helps deliver the most-effective treatments with the least impact on your child’s body.
Since neuroblastoma often has few symptoms, it may spread (metastasize) to other parts of the body before it is found. In early stages, it sometimes is found during routine examinations. Neuroblastoma is rarely found on an ultrasound before a baby is born.
Neuroblastoma diagnostic tests
If your child’s doctor suspects your child might have neuroblastoma, the first step will be a complete physical examination. The doctor will ask you questions about your child’s health.
One or more of the following diagnostic tests may be used to find out if your child has neuroblastoma and if it has spread. These tests also may be used to find out if treatment is working.
One of several imaging methods can be used to diagnose neuroblastoma, including:
- CT (computed tomography) scans
- MRI (magnetic resonance imaging) scans
- MIBG scan. A chemical called MIBG with radioactive iodine is injected into a vein. As it moves through the body, images are taken with a special camera.
- Bone scans
- PET (positive emission tomography) scans
If a tumor is seen on imaging tests, a biopsy will be done to confirm it is neuroblastoma. In a biopsy, the doctor removes a small amount of cells to look at with a microscope.
A biopsy for neuroblastoma is usually done one of the following ways:
- Surgery: An incision (cut) is made in the skin close to the tumor and cells from the tumor are removed.
- Needle biopsy: A thin, hollow needle is inserted into the tumor. Suction is applied to remove a small amount of tissue. If a tumor is difficult to reach, a CT scan may be used help guide the needle.
Bone marrow aspiration and biopsy
Blood and urine tests
Getting a second opinion at Children's Cancer Hospital
The pediatric cancer experts at Children’s Cancer Hospital welcome the opportunity to provide second opinions for neuroblastoma.
If you would like to get a second opinion at Children’s Cancer Hospital, call 855-508-4467 to make an appointment or request an appointment online.
Treatment for neuroblastoma often is complex. MD Anderson’s Children’s Cancer Hospital offers a team approach to neuroblastoma, bringing together some of the nation’s top experts to personalize your child’s course of treatment.
Your child’s care team will feature several physicians, including oncologists, surgeons, radiologists, radiation oncologists, as well as a highly specialized support staff. Their aim is to deliver therapies with the highest chance for success and the least impact on the growing body.
Surgical skill is key
Like all surgeries, neuroblastoma surgery is most successful when performed by a specialist with a great deal of experience in the particular procedure.
The surgeons at Children’s Cancer Hospital are highly specialized in neuroblastoma, and they are among the most skilled and renowned in the world. They perform a high number of surgeries for neuroblastoma each year, using the least-invasive and most advanced techniques.
We offer a range of clinical trials of innovative therapies for neuroblastoma, including high-risk, progressive and recurrent forms of the disease.
Our neuroblastoma treatments
Your child’s care for neuroblastoma will be customized to provide the most effective treatment with the least effect on the body. Your doctor will discuss treatment options with you. These are based on:
- Your child’s age and health
- The size, location and features of the tumor
- Whether the cancer has spread
Some low-risk neuroblastoma tumors will go away without any treatment, and others may be cured by surgery alone. However, many times the cancer has spread to other parts of the body and will require intensive combinations of treatment.
Neuroblastoma treatment often includes surgery to remove as much of the tumor as possible. Surrounding lymph nodes also may be removed to find out if the cancer has spread.
Sometimes, the entire tumor can be removed. However, if the tumor is close to important parts of the body or large blood vessels, only partial removal may be possible. In these cases, chemotherapy and radiation therapy are given after surgery.
Chemotherapy is sometimes given before surgery to make the tumor smaller and easier to remove.
Neuroblastoma often spreads to other parts of the body, such as the lymph nodes, bone marrow, liver, bones or lungs, before it is diagnosed. Chemotherapy travels all through the body, and that makes it effective in treating neuroblastoma.
Children’s Cancer Hospital offers the most up-to-date and advanced chemotherapy options for neuroblastoma. Chemotherapy may be given:
- Before surgery (neoadjuvant chemotherapy)
- After surgery (adjuvant chemotherapy)
- As the main treatment if the cancer cannot be removed by surgery
Radiation therapy (also called radiotherapy) uses high-energy beams to destroy cancer cells. New radiation therapy techniques, including proton therapy, and remarkable skill allow Children’s Cancer Hospital doctors to target neuroblastoma tumors more precisely, delivering the maximum amount of radiation with the least damage to healthy cells.
Some children with neuroblastoma receive radiation therapy:
- After surgery to stop or slow the growth of tumors that cannot be treated successfully with surgery and chemotherapy
- After a stem-cell transplant
- To help with symptoms such as pain and breathing difficulties
Children with advanced neuroblastoma may sometimes benefit from MIBG radiotherapy. A radioactive chemical is injected into the blood and travels directly to neuroblastoma tumor cells in the body.
High-dose chemotherapy/radiation therapy and stem cell transplant
Children with treatment-resistant, advanced neuroblastoma may benefit from a stem cell transplant.
Treatment with vitamin A or a vitamin A-like compound may be used in some patients.
Children’s Cancer Hospital is leading into the future of neuroblastoma treatment by developing innovative targeted therapies. These agents are specially designed to treat each cancer’s specific genetic/molecular profile to help your child’s body fight the disease. Many of the doctors who treat neuroblastoma at Children’s Cancer Hospital are dedicated researchers who have pioneered and actively lead national and international clinical trials with novel targeted agents.
Why choose MD Anderson for neuroblastoma care?
From diagnosis through survivorship, each neuroblastoma patient at MD Anderson's Children's Cancer Hospital is cared for by a highly specialized team of experts. This team follows your child closely, communicating frequently with your family and each other to provide the best possible care.
We are among the world's leading authorities in neuroblastoma, and we draw upon the most advanced therapies, technology and techniques to diagnose and treat your child.
Surgery is often a part of neuroblastoma treatment, and our surgeons have a high level of expertise and skill, which helps increase the chances of successful treatment. In addition, we offer the very latest in chemotherapy options.
Children's Cancer Hospital offers clinical trials for innovative new treatments for neuroblastoma. And, behind the scenes we are working on groundbreaking basic science research to change the future of pediatric cancer.
Treating the whole child
Children's Cancer Hospital is designed just for children, with a full range of services and amenities that help make the child and family's experience as comfortable as possible. We go beyond medical care to deliver a comprehensive experience that treats the whole child.
And at Children's Cancer Hospital, your child benefits from the expertise and resources of one of the nation's top cancer centers.
We would have tried anything to make him well, but we couldn’t have asked for better care.