Adrenal neuroblastoma in children. Analysis of clinical series of 6 cases

Abstract

Introduction. Neuroblastoma is the most common solid tumor in infants and young children and accounts for 8% of all childhood tumors. The prevalence is 1 in 7000 live births. Some studies show a two-phase incidence with a “pick” before the age of 1 year and the second between 2-4 years respectively. Neuroblastoma with localization in adrenal glands was found in each of 100 children who died in the first 3 months of life. The exact etiology remains unknown. Aim of the study. To highlight the: clinical, laboratory, imaging and histopathological particularities and also the results of the surgical treatment of the adrenal neuroblastoma, in stages IV and IV.S. Materials and methods. We conducted a retrospective and prospective study of a clinical series of patients with adrenal Neuroblastoma. Series, being analyzed from the perspective of the existing database in actual literature. We have evolved the clinical, laboratory and imaging particularities. Results. Patients were divided into 3 sides according to age (0-6) months -3 patients (50%), (6-12) months - 2 patients (33%), (> 12 months) - 1 patient (17% ). Gender distribution being: 2 girls (33%) and 4 boys (67%). Suggestive symptoms for the presence of a tumor were found preoperatively in 5 (83%) patients, with the exception of one patient in whom the tumor was found accidentally. The symptoms appeared in various associations in those patients. The diagnosis was established during the antenatal period for 1 (17%) patient, the other 5 (83%) - postnatal. Laboratory investigations revealed: anemia – 2 (33%) children, increased LDH activity in 4 children, increased ferritin in 4 (67%) cases. The value of the exploratory diagnostic imaging was clearly superior to the laboratory analyzes. Surgical treatment was performed in all 6 cases presented. All patients benefited from adjuvant treatment after surgical intervention. Adjuvant therapy consisted of the administration of Etoposide 50 mg, Doxorubicin 10 mg Carboplatin 10 mg, Cyclophosphanan 300 mg. Conclusions. The treatment of neuroblastoma is multimodal and depends on the extent of the lesions, the research data, the staging criteria. The neuroblastoma has a reserved prognosis when regional ganglia are involved and serum glycosylated ferritin is increased.