Neuroblastoma: report on a 21-year experience

Hypertensive retinopathy as the initial presentation of neuroblastoma

Purpose

To describe a case of a patient who presented with hypertensive retinopathy and was found to have neuroblastoma.

Observations

Neuroblastoma has three main ocular presentations. As a primary disease, it can present with a paraneoplastic syndrome in the form of opsoclonus, or it can present as a Horner's syndrome from its effect on the cervical sympathetic ganglia. Metastatic disease can present as a triad of periorbital edema, ecchymosis and proptosis from orbital bone involvement. Hypertension is a rare systemic presentation of neuroblastoma. We report the case of a two-year-old girl whose initial presentation of neuroblastoma was hypertensive retinopathy.

Conclusions and importance

To our knowledge, this is the first reported case of neuroblastoma presenting as hypertensive retinopathy. Our case highlights the importance of a multidisciplinary approach and thorough systemic work up of ocular findings in order to arrive at an appropriate diagnosis.

A case of neonatal neuroblastoma mimicking Altman type III sacrococcygeal teratoma

The authors report a case of neonatal neuroblastoma mimicking Altman type III sacrococcygeal teratoma. A newborn male infant delivered after a normal pregnancy was found to have an extremely large sacrococcygeal mass. Imaging studies strongly suggested Altman type III sacrococcygeal teratoma. On the 10th day after the birth, the tumor was incompletely removed at surgery. Histopathologic examination of the tumor showed neuroblastoma. The tumor disappeared completely after chemotherapy. One year after diagnosis, no local recurrence or metastasis had been detected. To the authors' knowledge, this is the first case of neonatal neuroblastoma mimicking Altman type III sacrococcygeal teratoma.

Intrarenal neuroblastoma masquerading as Wilms' tumor

OBJECTIVES

To better characterize intrarenal neuroblastoma.

METHODS

We retrospectively reviewed the records of 5 children with neuroblastoma initially diagnosed as Wilms' tumor.

RESULTS

Five patients, aged 11 months to 3.5 years, were preoperatively diagnosed as having intrarenal Wilms' tumor, prior to operative or histopathologic diagnosis of neuroblastoma. In 3 children the diagnosis of neuroblastoma involving the kidney was confirmed; in the fourth child subcutaneous metastatic disease precluded biopsy confirmation of the intrarenal tumor; and in the fifth child the kidney was severely displaced but not actually involved by neuroblastoma. All patients were hypertensive and 4 patients had elevated urinary catechol levels. Molecular genetic studies showed N-myc amplification in both patients who were evaluated. All patients had poorly differentiated histopathology. One patient is presently alive at 8 months with recurrent disease and another patient is free of disease 13 years after diagnosis. The remaining 3 patients died of the malignancy.

CONCLUSIONS

Intrarenal neuroblastoma is a rare entity that clinically and radiographically may resemble Wilms' tumor. Our limited experience indicates that intrarenal neuroblastoma is an aggressive malignancy, and long-term survival is rare.