Pediatric Emergency Medicine Journal  2016;3(2):59-64

doi:10.22470/pemj.2016.3.2.59

Neuroblastoma in a 3-year-old boy presenting with pain in the bilateral hip and abdomen.

Jae Hyun KWON 1 ; Jung Heon KIM ; In Hye SONG ; Jeong Min RYU

Affiliations

+expand

Keywords

Child; Diagnosis, Differential; Emergencies; Hip; Neuroblastoma; Pain

Country

Republic of Korea

Language

Korean

Abstract

A 3-year-old boy presented to our emergency department with a 3-week history of pain in the bilateral hip and abdomen that had persisted through antibiotic therapy based on diagnosis of acute osteomyelitis. At presentation, he had fever, anemia, and increased concentration of lactate dehydrogenase. After the identification of a left adrenal mass indicating neuroblastoma on computed tomography scan, he was admitted to the hospital by a pediatric oncologist. Subsequently, positron emission tomography and bone scintigraphy showed disseminated metastasis to the bone and bone marrow, and neuroblastoma was pathologically confirmed. This case highlights the importance of differential diagnosis of non-traumatic hip pain in toddlers considering the protean manifestations of neuroblastoma.