Neuroblastoma

Question 1

What is a neuroblastoma?

Answer 1

A solid tumour that arises from the sympathetic nervous system. It is an embryonal neoplasm of early childhood.

Question 2

Under what age do they usually occur?

Answer 2

5 years

Question 3

Why is it difficult to pick up in primary care?

Answer 3

1. Rare
2. Vague symptoms

Question 4

At what sites do neuroblastomas usually form?

Answer 4

Adrenal and paraspinal

Question 5

What % have metastases at the time of diagnosis?

Answer 5

60%

Question 6

What is the most common symptom of a neuroblastoma?

Answer 6

A lump in the abdomen which can cause swelling or pain.

Question 7

What are some other features that should make you think neuroblastoma & refer urgently?

Answer 7

• Proptosis
• Unexplained back pain
• The tumour can compress the spinal cord causing:
  
  • Leg weakness
  • Unexplained urinary retention

Question 8

What are some symptoms of metastatic disease?

Answer 8

• Similar to leukaemia:
  
  • Malaise
  • Pallor
  • Bone pain
  • Irritability
  • Fever
  • Respiratory symptoms

Question 9

What are some signs of catacholamine release?

Answer 9

• Tachycardia
• Flushing
• Sweating
• Weight loss
• Watery diarrhoea

Question 10

What investigations should be done if neuroblastoma is suspected?

Answer 10

• Urgent Abdo USS - make an urgent referral if a mass is identified.
• CXR
• FBC