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Neuroblastoma

About neuroblastoma in children

Neuroblastoma is a tumor that arises from the neural crest/sympathetic nerve cells. It can occur anywhere in your body, but the abdomen (above the kidney) and chest are the most common places.

For infants, it is the most common malignancy (abnormal cells that divide without control and can invade nearby tissues), with the median age of diagnosis being about 22 months. It is very rare beyond 10 years.

Neuroblastoma accounts for about 8-10% of all pediatric cancers, but it is still a rare tumor, occurring in about one in 700 live births.

Causes of neuroblastoma

There is no known cause of neuroblastoma. While some genes have been implicated, there is no strong evidence for this running in families.

Neuroblastoma has been seen in-utero during prenatal ultrasound. These cases tend to disappear/resolve spontaneously, making it possible that neuroblastoma is due to changes in embryonic development of the neuronal cells.

Signs of neuroblastoma

The most common signs are abdominal pain, swelling and not feeling well in general. Some infants can present with black spots on their skin, which are sometimes called “blueberry muffin baby” or with dark discolorations under the eye.

How is neuroblastoma diagnosed?

Neuroblastoma needs a variety of tests to detect and determine the extent of spread. Our pediatric oncologists usually start with a CT scan or ultrasound, followed by a biopsy to determine the type of tumor and its characteristics.

A specialized scan called I-MIBG scan helps detect if cancer has spread to other places and can be used to see if the treatment is working. Urine tests for tumor markers as well as bone marrow biopsy are other tests that are needed.

How is neuroblastoma treated?

Early-stage tumors, a tumor that is in only one place, can be surgically removed. To help determine the best treatment, we look at factors such as the age of the child, the characteristics of the tumor under the microscope and genetic markers in the tumor to determine further chemotherapy (intermediate stages).

Neuroblastoma that has spread to other parts of the body is particularly hard to treat. If the tumor has spread to multiple other areas of the body, your child might need multi-modal therapy, which includes chemotherapy, surgery, radiation, an autologous stem cell transplant and immunotherapy with monoclonal antibodies. This is a long and rigorous treatment, but we are here for you every step of the way.

There are multiple newer treatments as well as clinical trials that have shown promising results. For the next level of care, we partner with other institutions around the country to provide the latest available treatments.

What is the survival outlook for children?

Children in the early stage of neuroblastoma do extremely well with more than 95%  surviving more than five years. Children in the intermediate stage do well with a 90-95% survival rate. There is about a 50% survival rate in the high-risk group. We're committed to providing the best treatments and most thorough care to fight this cancer.

We understand that this is a scary time for you and your family. Helping you best navigate treatment options and maintain a healthy outlook for your child and your entire family is at the heart of our approach. You’re never in this alone. 

Learn more about CHoR’s cancer care