Presacral cystic neuroblastoma: case report and review of the literature

Congenital Sacrococcygeal Neuroblastoma: A Report of Two Cases with Summary of Prior Published Cases

BackgroundNeuroblastoma can arise from extra-adrenal sites in the paraspinal sympathetic chain, including the presacral region, where they must be differentiated from an immature or malignant neural lesion arising from a teratoma.Case ReportWe describe two congenital presacral neuroblastomas. The main clinical differential diagnoses were sacrococcygeal teratoma and meningomyelocele. Pathologically, they lacked teratomatous tissues, lacked germ cell serum markers, were localized without metastases, and were MYCN non-amplified. Both patients have done well without chemotherapy at 18 and 15 months of follow-up.ConclusionCongenital presacral neuroblastoma should be differentiated from teratomatous lesions, and in general have a good prognosis.

A Rare Case of Congenital Orbital Cystic Neuroblastoma in an Infant

Neuroblastoma, a relatively common tumor in infants, is rarely present at birth. A solid mass is the typical appearance of this neoplasm, while cystic formation is uncommon. Congenital cystic neuroblastoma is extremely rare and no previous report exists of its occurrence in the orbit. A newborn girl was referred with an extremely large mass on the right side of her face on the third day of her life. Prenatal ultrasonography had revealed a large mass (80 × 80 mm) in the frontal area. MRI revealed a heterogeneous mass composed of cystic and solid, contrast-enhancing components. Excisional biopsy was successfully performed and histopathologic diagnosis of neuroblastoma was confirmed. Systemic workup was negative for involvement of other organs and levels of catecholamine metabolites of serum and urine (homovanillic acid and vanillylmandelic acid) were normal. Postoperative course was uneventful with complete healing of the anophthalmic socket and normal physical and mental growth and development of the infant. To our knowledge, this is the first report of congenital cystic neuroblastoma primarily arising in the orbit.

A rare case of presacral cystic neuroblastoma in an infant

Cystic neuroblastoma (CN) is an extremely rare entity, although neuroblastoma is the most common solid tumor in infants. The radiologic diagnosis of CN is very difficult because of both the rarity and minimum solid component of the lesion. We describe herein the case of a 2-month-old girl presenting with dysuria because of a large presacral mass. Imaging studies including ultrasonography, computed tomography, and magnetic resonance imaging demonstrated a large septated cystic tumor mimicking a cystic sacrococcygeal teratoma, which commonly occurs in the presacral region. The tumor was finally diagnosed as CN after surgical resection. This is the second case report of presacral CN in the English literature. Cystic neuroblastoma should be considered in the differential diagnosis of presacral cystic tumors in infants.