Neuroblastoma: what it is, symptoms, diagnosis and treatment

Neuroblastoma is a type of cancer that affects the cells of the sympathetic nervous system, which is responsible for preparing the body to respond to emergency and stress situations. This type of tumor develops in children up to 5 years, but the diagnosis is more common to happen between 1 and 2 years, and can start in the nerves of the chest, brain, abdomen or in the adrenal glands that are located over each kidney.

Children under 1 year of age and with small tumors have a greater chance of cure, especially when instituted early treatment. When the diagnosis is made early and does not present metastases, the neuroblastoma can be surgically removed without the need for radiotherapy or antineoplastic medication. Thus, the early diagnosis of neuroblastoma has a positive impact on the child's survival and quality of life.

Main signs and symptoms of Neuroblastoma

The signs and symptoms of neuroblastoma vary according to the location and size of the tumor, in addition to whether there has been dissemination or not and whether the tumor produces hormones. In general, the signs and symptoms indicative of neuroblastoma are:

  • Abdominal pain and enlargement;
  • Bone pain;
  • Loss of appetite;
  • Weight loss;
  • General malaise;
  • Excessive tiredness;
  • Fever;
  • Diarrhea;
  • Hypertension, due to the production of hormones by the tumor that lead to vasoconstriction of the vessels;
  • Liver enlargement;
  • Swollen eyes;
  • Different sized pupils;
  • Absence of sweat;
  • Headache;
  • Swelling in the legs;
  • Difficulty breathing;
  • Emergence of bruises;
  • Appearance of nodules in the abdomen, lumbar, neck or chest.

As the tumor grows and spreads, symptoms that are more specific to the site of metastasis may appear. As the symptoms are not specific, they can vary from child to child, they can be similar to other diseases, and the incidence of the disease is low, neuroblastoma is often not diagnosed. However, it is very important that the diagnosis is made as soon as possible to avoid spreading the tumor and worsening the disease.

How is the diagnosis

The diagnosis of neuroblastoma is made through laboratory and imaging tests that must be recommended by the doctor, since diagnosis based on symptoms alone is not possible. Among the tests requested is the measurement of catecholamines in the urine, which are hormones normally produced by the cells of the sympathetic nervous system, and which in the bloodstream give rise to metabolites whose quantity is verified in the urine.

In addition, complete blood count and imaging tests, such as chest and abdomen X-rays, ultrasound, tomography, magnetic resonance and bone scintigraphy, for example, are indicated. To complete the diagnosis, a biopsy may also be requested to confirm that it is a malignant disorder. Understand what it is for and how the biopsy is done.

How the treatment is done

Neuroblastoma treatment is done according to the person's age, general health, tumor location, size and stage of the disease. In the early stages, treatment is done only with surgery to remove the tumor, without the need for any additional treatment.

However, in cases where metastasis has been detected, chemotherapy may be necessary to decrease the multiplication rate of malignant cells and, consequently, the tumor size, followed by surgery and complementary treatment with chemotherapy and radiotherapy. In some more serious cases, especially when the child is very young, bone marrow transplantation after chemo and radiation therapy may be recommended.