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Neuroblastoma

Neuroblastoma is a rare cancer which develops from the nerve cells present in several parts of the body. It is more common in one of the adrenal glands present above the kidneys. However, neuroblastoma can also develop in the areas such as the tummy, chest, neck and runs alongside the spine. From these tissues it can spread to the other organs in the body.

Symptoms

The symptoms of neuroblastoma depend on the part of the body which is affected.

Symptoms of neuroblastoma in the abdomen include:

  • Abdominal pain and swelling
  • Diarrhea or constipation
  • Difficulty to pass urine
  • Formation of a mass under the skin

Symptoms of neuroblastoma in the chest include:

  • Chest pain
  • Wheezing
  • Breathlessness
  • Drooping eyelids and unequal pupil size

The other symptoms which may be noticed in patients with neuroblastoma are:

  • Formation of lumps under the skin
  • Dark circles around the eyes which appear as bruises
  • Protrusion of eyeballs from the sockets
  • Bone pain
  • Back pain
  • Unusual weight loss
  • Unsteady walk associated with weakness in the legs

Causes

Neuroblastoma begins in the neuroblasts, which are the immature nerve cells that form during the fetal development in the womb.

The exact cause of neuroblastoma is not clear yet. It is believed that neuroblastoma occurs when there is a mutation in the genes which leads to the uncontrolled multiplication of the neuroblast cells. These abnormal cells form a mass known as tumor.

Risk factors

Neuroblastoma most commonly affects babies and young children, aged less than 5 years. A family history is found to rarely increase the likelihood of a child to develop neuroblastoma.

Complications

The following complications can occur if neuroblastoma is not treated properly:

  • The cancer cells can spread to the other parts such as bone, bone marrow, lymph nodes, skin and liver.
  • Growth of the tumor creates pressure on the spinal cord leading to pain or even paralysis.
  • Certain chemical substances released by the neuroblastoma cells can lead to paraneoplastic syndrome. It involves irritation of the normal tissues causing symptoms such as problems with coordination and rapid eye movements. Sometimes there can be abdominal swelling and diarrhea.

Diagnosis

If the doctor suspects that a child has neuroblastoma, then he or she will carry out several tests to confirm the condition and detect the type of neuroblastoma. These tests may include:

  • Urine tests are performed to detect the presence of certain chemicals in urine which are usually produced by the neuroblastoma cells.
  • Imaging tests such as an MRI, CT scan or an ultrasound are required to view the affected areas in detail.
  • MIBG scan involves the injection of a radioactive substance which will be readily taken up by the neuroblastoma cells and therefore, it helps to locate neuroblastoma.
  • Tissue biopsy is performed by taking a sample of the suspected tissue which is examined under microscope.
  • A bone marrow biopsy may be performed if the doctor suspects the spread of cancer to the bones.

Additionally, the exact stage of the cancer is identified from the above tests and the treatment is initiated accordingly.

Treatment

Treatment may not be required for certain types of neuroblastoma. The choice of the treatment depends on several factors such as age of the child, stage of the cancer and the type of cancer cells. The main treatment options for neuroblastoma include:

If there is a low-risk neuroblastoma, then the tumor can be completely removed only by surgery. The surgeon uses specialized tools and scalpels to remove the tumor.

If there is an intermediate to high-risk neuroblastoma, then the surgeon removes as many tumors as possible. This is followed by other therapies such as chemotherapy and radiation therapies to kill the remaining cancer cells. Chemotherapy involves the use of chemical substances which targets and destroys the rapidly growing cells including cancer cells. Radiation therapy uses high-energy x-rays to destroy the cancer cells.

Patients with high-risk neuroblastoma may also benefit from stem cell transplantation. Stem cells are collected from the child’s own blood and stored under frozen temperature. After an intensive chemotherapy is given to kill the cancer cells, these stem cells are injected into the body to form healthy new cells.

Immunotherapy is another option in which medicines are given to stimulate the immune system to destroy the neuroblastoma cells.

 

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