Fine needle aspiration has been effectively being applided to pediatric tumors since it renders a rapid diagnosis with minimal intervention. This measure is especially required for the large pediatric mass, which needs preoperative chemotherapy or radiotherapy to shrink the tumor to an operable size. A case of neuroblastoma of mediastinum, stage IV diagnosed by CT-guided FNA is described.
Biopsy, Fine-Needle* ; Diagnosis ; Drug Therapy ; Mediastinum* ; Neuroblastoma* ; Radiotherapy

Intensive chemotherapy with or without stem cell rescue has become widely accepted for treatment of neuroblastoma because increased dose-intensity correlates with improved response rates. For neuroblastoma that is resistant to intensive chemotherapy, further use of high-dose therapy is unlikely to be beneficial. For disease that recurs after myeloablative consolidation, high-dose salvage therapy may not be feasible because of poor bone marrow reserve and may not be justified in view of its morbidity in the absence of a realistic chance for cure. One treatment option in these difficult clinical settings is chronic oral administration of low-dose etoposide. However, there has been a few clinical reports for the experience of oral etoposide for refractory neuroblastoma. We now present 2 cases of successful response of oral etoposide for refractory neuroblastoma.
Administration, Oral ; Bone Marrow ; Drug Therapy ; Etoposide* ; Neuroblastoma* ; Salvage Therapy ; Stem Cells

BACKGROUND: The aim of this study is to evaluate the histologic features of metastatic neuroblastic tumors (NTs) in bone marrow (BM) before and after chemotherapy in comparison with those of primary NTs. METHODS: A total of 294 biopsies from 48 children diagnosed with NTs with BM metastasis were examined. There were 48 primary neoplasm biopsies, 48 BM biopsies before chemotherapy, 36 primary neoplasm excisional biopsies after chemotherapy, and 162 BM biopsies after chemotherapy. RESULTS: Metastatic NTs in BM before chemotherapy were composed of undifferentiated and/or differentiating neuroblasts, but had neither ganglion cells nor Schwannian stroma. Metastatic foci of BM after chemotherapy were found to have differentiated into ganglion cells or Schwannian stroma, which became more prominent after further cycles of chemotherapy. Persistence of NTs or tumor cell types in BM after treatment did not show statistically significant correlation to patients' outcome. However, three out of five patients who newly developed poorly differentiated neuroblasts in BM after treatment expired due to disease progression. CONCLUSIONS: Metastatic NTs in BM initially consist of undifferentiated or differentiating neuroblasts regardless of the primary tumor subtype, and become differentiated after chemotherapy. Newly appearing poorly differentiated neuroblasts after treatment might be an indicator for poor prognosis.
Biopsy ; Bone Marrow* ; Child ; Drug Therapy* ; Ganglion Cysts ; Humans ; Neoplasm Metastasis ; Neuroblastoma ; Prognosis

PURPOSE: A case of proptosis due to orbital metastasis of neuroblstoma and review of the current literature on neuroblastoma METHODS: A 8-month-old female presented with proptosis due to neuroblastoma involving skull and bone marrow. RESULTS: Proptosis was improved following chemotherapy. CONCLUSIONS: In case of infant who has a proptosis and periorbital ecchymosis without a primary lesion or a specific history, neuroblastoma may be considered as a differential diagnosis.
Bone Marrow ; Diagnosis, Differential ; Drug Therapy* ; Ecchymosis ; Exophthalmos* ; Female ; Humans ; Infant ; Neoplasm Metastasis ; Neuroblastoma* ; Orbit ; Skull

PURPOSE: Neuroblastoma is a malignant neoplasm which arises from primitive sympathetic neuroblasts, and occasionally can matured from a malignant neuroblastoma into a benign ganglioneuroma. It has the highest rate of spontaneous regression of any pediatric tumor. We performed a retrospective study of pathologic features after combination therapy in advanced neuroblastoma. Prognostic effects of the individual morphologic feature and prognostic groupings according to modified Shimada classification systems were analyzed. METHODS: The treatment results for six patients with neuroblastoma seen at Keimyung University from Jan. 1991 to June 2000 were analyzed. Patients were treated with a combination of chemotherapy, radiation therapy, and surgery, and classified by two major prognostic criteria based on morphological features of neuroblastoma, such as modified Shimada classification and histologic grading. RESULTS: Three cases were classified to a good histologic group; among them, two cases survived, but one case was lost in follow-up. There were three cases classified in a poor histologic group. All of these patients expired due to sepsis and hemorrhagic pancreatitis. CONCLUSION: Prognostic classification due to pathologic findings had significant value in evaluating the survival rate of neuroblastoma patients.
Classification ; Drug Therapy ; Follow-Up Studies ; Ganglioneuroma ; Humans ; Neuroblastoma* ; Pancreatitis ; Prognosis* ; Retrospective Studies ; Sepsis ; Survival Rate

Neuroblastoma stage IV-S patients have frequent spontaneous remission and high survival rate. Many investigators have recommended minimal or no therapeutic intervention ; however, some patient do experience progressive disease and ultimately die of neuroblastoma. We experienced a case of stage IVS neuroblastoma with N-myc amplification and coagulopathy. This patient has treated with combination chemotherapy and radiation therapy, then remained disease free for 1 year on the follow up till March, 1997.
Drug Therapy, Combination ; Follow-Up Studies ; Humans ; Neuroblastoma* ; Remission, Spontaneous ; Research Personnel ; Survival Rate

Although neuroblastoma occurs most frequently in children, it also may occur in adults and has been considered poor prognosis. Herein one case of retroperitoneal neuroblastoma developed in a 20 year-old female is presented, treated with debulking surgery and combination chemotherapy.
Adult* ; Child ; Drug Therapy, Combination ; Female ; Humans ; Neuroblastoma* ; Prognosis ; Young Adult

Spontaneous rupture with internal bleeding of solid tumors has rarely been described at the time of diagnosis or during chemotherapy. This rare event must be regarded as a life threatening condition. In these emergency situations, control of hemorrhage, which is life-saving, can be achieved by transcatheter arterial embolization (TAE) and/or surgical resection. This report describes two infants presenting with acute hemorrhagic shock due to spontaneous tumor rupture of hepatoblastoma and neuroblastoma during chemotherapy. TAE successfully arrested the tumor bleeding and a visibly reduced the tumor size in both children. Spontaneous rupture of solid tumors occur infrequently in children, but is a life threatening situation. Careful monitoring for the occurrence of this rare event especially in very young children presenting with a large tumor mass.
Child ; Diagnosis ; Drug Therapy ; Emergencies ; Hemorrhage ; Hepatoblastoma ; Humans ; Infant ; Neuroblastoma ; Rupture ; Rupture, Spontaneous ; Shock, Hemorrhagic

We report a case of neuroblastoma with multiple skin metastases as a chief complaint in a 2-month-old girl. the skin lesions were rnultiple, pea-sized, bluish, nontender, moable subcutaneous nodules on abdomen, back and scalp. Histopathology showed small round or poly gonal tumor cells which have deeply stained, basophilic, hyperchromatic nuclei with some mitoses. Th.se tumor cells showed clumping tendency which is one of early menifestations of rosette formation. Immunohistochemically positive reaction was demonstrated by anti-NSE(neuron specific enolase) antilody but negative reaction by anti-NFP (neurofilament proteiin ) antibody. She has been succesfully treated with combined chemotherapy for 10 months without relapse.
Abdomen ; Basophils ; Drug Therapy ; Female ; Humans ; Infant ; Mitosis ; Neoplasm Metastasis* ; Neuroblastoma* ; Phosphopyruvate Hydratase ; Recurrence ; Rosette Formation ; Scalp ; Skin*

Neuroblastoma originate in neural crest and is one of the most frequent tumor next to leukemia and brain tumor in child. The tumor is most highly malignant tumor due to early metastasis at diagnosis. It could be diagnosed by various diagnostic modalities such as roentgenologic examination, laboratory data and confirmed by pathologic diagnosis. Management of neuroblastoma is surgery, radiotherapy and chemotherapy. We experienced a case of adrenal neuroblastoma at age of 20-month male child and report with a brief review of literature
Adrenal Glands ; Brain Neoplasms ; Child ; Diagnosis ; Drug Therapy ; Humans ; Leukemia ; Male ; Neoplasm Metastasis ; Neural Crest ; Neuroblastoma* ; Radiotherapy