Abstract
Background
Routine antenatal ultrasound scans increased the detection of the neuroblastoma (NB) in neonates. We reviewed the treatment outcome and clinical presentation of neonatal NB.
Methods
We included patients who had pathologically confirmed NB presented within 28 days after birth from January 1999 to December 2010.
Results
There were 17 patients (8 females and 9 males), which consist of 16 % of total NB cases of children in our institution. Nine were followed from prenatal period as an abdominal mass and eight were presented postnatally (5 abdominal distensions, 2 tachypnea, and 1 persistent jaundice). The primary lesion was located in adrenal gland in ten patients, retroperitoneum in four, and posterior mediastinum in three. The tumor size was median 4.1 cm (range, 3–7). The stage of the patients were as follows: stage 1 in six, stage 2 in one, stage 3 in three, stage 4S in five, and stage 4 in two. Six patients were in the low-risk group, seven were intermediate-risk group, and four were high-risk group. Thirteen showed favorable histology among 15 specimens. Five patients (29.4 %) showed MYCN amplification. The median follow-up period was 78.4 months (range, 17.4–138.6). Fifteen of 17 (88.2 %) are alive without evidence of recurrences and two patients of stage 4S with MYCN amplification in high-risk group died.
Conclusions
The overall survival of neonatal NB is 88.2 %, but we observed a high ratio of stage 4 and stage 4S tumors and MYCN amplification. We suggested that early treatment might be better for neonatal NB more than 3 cm in size. Aggressive treatment for neonatal NB could bring more favorable outcome.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Bader JL, Miller RW (1979) US cancer incidence and mortality in the first year of life. Am J Dis Child 133:157–161
Everson TC, Cole WH (1959) Spontaneous regression of malignant disease. JAMA 169:1758–1759
Moppett J, Haddadin I, Foot AB (1999) Neonatal neuroblastoma. Arch Dis Child Fetal Neonatal Ed F134–F137
Dhir S, Wheeler K (2010) Neonatal neuroblastoma. Early Hum Dev 86:601–605
Gigliotti AR, Di Cataldo A, Sorrentino S et al (2009) Neuroblastoma in the newborn. A study of the Italian Neuroblastoma Registry. Eur J Cancer 45:3220–3227
Granata C, Fagnani AM, Gambini C et al (2000) Features and outcome of neuroblastoma detected before birth. J Pediatr Surg 35:88–91
Saylors RL III, Cohn SL, Morgan ER et al (1994) Prenatal detection of neuroblastoma by fetal ultrasonography. Am J Pediatr Hematol Oncol 16:356–360
Acharya S, Jayabose S, Kogan SJ et al (1997) Prenatally diagnosed neuroblastoma. Cancer 80:304–310
Look AT, Hayes FA, Shuster JJ et al (1991) Clinical relevance of tumor cell ploidy and N-myc gene amplification in childhood neuroblastoma: a Pediatric Oncology Group study. J Clin Oncol 9:581–591
Brodeur GM, Azar C, Brother M et al (1992) Neuroblastoma. Effect of genetic factors on prognosis and treatment. Cancer 70:1685–1694
Isaacs H Jr (2007) Fetal and neonatal neuroblastoma: retrospective review of 271 cases. Fetal Pediatr Pathol 26:177–184
Nuchtern JG (2006) Perinatal neuroblastoma. Semin Pediatr Surg 15:10–16
Ho PT, Estroff JA, Kozakewich H et al (1993) Prenatal detection of neuroblastoma: a ten-year experience from the Dana-Farber Cancer Institute and Children’s Hospital. Pediatrics 92:358–364
Beckwith JB, Perrin EV (1963) In situ neuroblastoma: a contribution to the natural history of neural crest tumors. Am J Pathol 43:1089–1104
Yamagiwa I, Obata K, Saito H (1998) Prenatally detected cystic neuroblastoma. Pediatr Surg Int 13:215–217
Horiuchi A, Watanabe Y, Miyauchi K et al (2008) Prenatally detected cystic adrenal neuroblastoma. Pediatr Int 50:130–131
Fox NS, Streltzoff J, Chasen ST (2008) Spontaneous resolution of an adrenal mass seen on ultrasound at 17 weeks gestation. J Pediatr Hematol Oncol 30:405–406
Jennings RW, LaQuaglia MP, Leong K et al (1993) Fetal neuroblastoma: prenatal diagnosis and natural history. J Pediatr Surg 28:1168–1174
Curtis MR, Mooney DP, Vaccaro TJ et al (1997) Prenatal ultrasound characterization of the suprarenal mass: distinction between neuroblastoma and subdiaphragmatic extralobar pulmonary sequestration. J Ultrasound Med 16:75–83
Ferraro EM, Fakhry J, Aruny JE et al (1998) Prenatal adrenal neuroblastoma: a case report with review of the literature. J Ultrasound Med 7:275–278
Martinez-Mora J, Castellvi A, Coroleu W et al (1995) Cystic adrenal neuroblastoma: prenatal diagnosis by ultrasonography. Med Pediatr Oncol 24:109–115
Smith JA Jr, Middleton RG (1979) Neonatal adrenal hemorrhage. J Urol 122:674–677
Holgerson LO, Subramanian S, Kirpekar M et al (1996) Spontaneous resolution of antenatally diagnosed adrenal masses. J Pediatr Surg 31:153–155
Chen CP, Chen SH, Chuang CY et al (1997) Clinical and perinatal sonographic features of congenital adrenal cystic neuroblastoma: a case report with review of the literature. Ultrasound Obstet Gynecol 10:68–73
Hero B, Simon T, Spitz R et al (2008) Localized infant neuroblastomas often show spontaneous regression: results of the prospective trials NB95-S and NB97. J Clin Oncol 26:1504–1510
Kerbl R, Urban CE, Lackner H et al (1996) Connatal localized neuroblastoma. A case to delay treatment. Cancer 77:1395–1401
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Nam, SH., Kim, D.Y., Kim, S.C. et al. Neonatal Neuroblastoma needs the Aggressive Treatment?. World J Surg 36, 2102–2107 (2012). https://doi.org/10.1007/s00268-012-1632-y
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00268-012-1632-y