1
|
Magnier O, Schiff I, Cristante J, Chabre O, Veloso M, Bosson JL, Defachelles AS, Cordero C, Cao CD, Thebaud E, Drui D, Berlanga P, Dumont B, Chastagner P, Tandonnet J, Gambart M, Jannier S, Pluchart C, Andry L, Laithier V, Klein S, Carausu L, Akbaraly T, Probert J, Habert-Dantigny R, Plantaz D. Adolescent- and adult-onset neuroblastic tumor: A retrospective multicenter observational study of patients diagnosed in France between 2000 and 2020. Pediatr Blood Cancer 2024; 71:e31074. [PMID: 38778452 DOI: 10.1002/pbc.31074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2024] [Revised: 04/27/2024] [Accepted: 04/30/2024] [Indexed: 05/25/2024]
Abstract
BACKGROUND Adult- and adolescent-onset neuroblastomas are rare, with no established therapy. In addition, rare pheochromocytomas may harbor neuroblastic components. This study was designed to collect epidemiological, diagnostic and therapeutic data in order to better define the characteristics of malignant peripheral neuroblastic tumors (MPNT) and composite pheochromocytomas (CP) with MPNT. PROCEDURE Fifty-nine adults and adolescents (aged over 15 years) diagnosed with a peripheral or composite neuroblastic tumor, who were treated in one of 17 institutions between 2000 and 2020, were retrospectively studied. RESULTS Eighteen patients with neuroblastoma (NB) or ganglioneuroblastoma (GNB) had locoregional disease, and 28 patients had metastatic stage 4 NB. Among the 13 patients with CP, 12 had locoregional disease. Fifty-eight percent of the population were adolescents and young adults under 24 years of age. The probability of 5-year event-free survival (EFS) was 40% (confidence interval: 27%-53%). CONCLUSIONS Outcomes were better for patients with localized tumor than for patients with metastases. For patients with localized tumor, in terms of survival, surgical treatment was the best therapeutic option. Multimodal treatment with chemotherapy, surgery, radiotherapy, and immunotherapy-based maintenance allowed long-term survival for some patients. Adolescent- and adult-onset neuroblastoma appeared to have specific characteristics associated with poorer outcomes compared to pediatric neuroblastoma. Nevertheless, complete disease control improved survival. The presence of a neuroblastic component in pheochromocytoma should be considered when making therapeutic management decisions. The development of specific tools/resources (Tumor Referral Board, Registry, biology, and trials with new agents or strategies) may help to improve outcomes for patients.
Collapse
Affiliation(s)
- Orlane Magnier
- Cancer and Blood Diseases Department, Medical Oncology, Grenoble Alpes University Hospital, Grenoble, France
| | - Isabelle Schiff
- Pediatric Oncology and Hematology Department, Grenoble Alpes University, Grenoble, France
| | - Justine Cristante
- Endocrinology Department, Grenoble Alpes University, Grenoble, France
| | - Olivier Chabre
- Endocrinology Department, Grenoble Alpes University, Grenoble, France
| | - Melanie Veloso
- Public Health and Biostatistics, Grenoble Alpes University Hospital, Grenoble, France
| | - Jean-Luc Bosson
- Public Health and Biostatistics, Grenoble Alpes University Hospital, Grenoble, France
| | | | - Camille Cordero
- Pediatric Oncology Department, Curie Institute, Paris, France
| | - Christine Do Cao
- Department of Endocrinology, Diabetology, and Metabolism, Lille University Hospital, Lille, France
| | - Estelle Thebaud
- Pediatric Oncology Department, Nantes University Hospital, Nantes, France
| | - Delphine Drui
- Endocrinology Department, Nantes University Hospital, Nantes, France
| | - Pablo Berlanga
- Pediatric and AYA Oncology Department, Gustave Roussy Institute, Paris, France
| | | | - Philippe Chastagner
- Pediatric Oncology and Hematology Department, Nancy University Hospital, Nancy, France
| | - Julie Tandonnet
- Pediatric Oncology Department, Bordeaux University Hospital, Bordeaux, France
| | - Marion Gambart
- Pediatric Oncology and Hematology Department, Toulouse University Hospital, Toulouse, France
| | - Sarah Jannier
- Pediatric Oncology Department, Strasbourg University Hospital, Strasbourg, France
| | - Claire Pluchart
- Pediatric Oncology and Hematology Department, Reims University Hospital, Reims, France
| | - Leslie Andry
- Pediatric Oncology Department, Amiens University Hospital, Amiens, France
| | - Véronique Laithier
- Pediatric Oncology Department, Besançon University Hospital, Besançon, France
| | - Sébastien Klein
- Pediatric Oncology Department, Besançon University Hospital, Besançon, France
| | - Liana Carausu
- Pediatric Oncology and Hematology Department, Brest University Hospital, Brest, France
| | - Tasmine Akbaraly
- Pediatric Oncology Department, Montpellier University Hospital, Montpellier, France
| | - Jamie Probert
- Pediatric Oncology and Hematology Department, Rennes University Hospital, Rennes, France
| | - Raphaelle Habert-Dantigny
- Cancer and Blood Diseases Department, Medical Oncology, Palliative Care Unit, Grenoble Alpes University, Grenoble, France
| | - Dominique Plantaz
- Pediatric Oncology and Hematology Department, Grenoble Alpes University, Grenoble, France
| |
Collapse
|
2
|
Zhang X, Zhang Y, Peng D, Shi X, Zhang Z, Wang J, Zhang X, Leng J, Li W. Adrenal ganglioneuroblastoma with metastasis near the renal hilum in an adult female: A case report and review of the literature. Oncol Lett 2024; 27:187. [PMID: 38486945 PMCID: PMC10938287 DOI: 10.3892/ol.2024.14319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Accepted: 02/12/2024] [Indexed: 03/17/2024] Open
Abstract
Ganglioneuroblastoma (GNB), predominantly observed in children, is an uncommon malignant tumor in adults, with established treatment protocols notably lacking. The present study details the case of a 20-year-old woman who presented with a left adrenal gland mass, identified during a physical examination. Additionally, an unidentified mass was noted near the renal hilum in the preoperative evaluation. Following thorough preoperative preparation, both the primary adrenal gland mass and the renal hilar mass were surgically removed. The procedure concluded successfully. Pathological analysis confirmed that the left adrenal mass was a GNB and identified the renal hilar mass as a metastatic extension. Postoperative examination revealed a new formation at the original surgical site, later verified as a postoperative scar. Through the publication of a case report and extensive literature review, the present study aims to enhance our understanding of this condition, providing valuable diagnostic, therapeutic and post-recovery references for this rare adult disease.
Collapse
Affiliation(s)
- Xinzhang Zhang
- Department of Urology, The Affiliated Hospital of Kunming University of Science and Technology, The First People's Hospital of Yunnan Province, Kunming, Yunnan 650100, P.R. China
- Medical School, Kunming University of Science and Technology, Kunming, Yunnan 650500, P.R. China
| | - Yiwen Zhang
- Medical School, Kunming University of Science and Technology, Kunming, Yunnan 650500, P.R. China
| | - Dan Peng
- Medical School, Kunming University of Science and Technology, Kunming, Yunnan 650500, P.R. China
| | - Xin Shi
- Medical School, Kunming University of Science and Technology, Kunming, Yunnan 650500, P.R. China
| | - Zhuorui Zhang
- Department of Urology, The Affiliated Hospital of Kunming University of Science and Technology, The First People's Hospital of Yunnan Province, Kunming, Yunnan 650100, P.R. China
| | - Junfeng Wang
- Medical School, Kunming University of Science and Technology, Kunming, Yunnan 650500, P.R. China
| | - Xue Zhang
- Department of Management Science and Information System, Faculty of Management and Economics, Kunming University of Science and Technology, Kunming, Yunnan 650500, P.R. China
| | - Jinjun Leng
- Department of Urology, The Affiliated Hospital of Kunming University of Science and Technology, The First People's Hospital of Yunnan Province, Kunming, Yunnan 650100, P.R. China
| | - Wei Li
- Department of Urology, The Affiliated Hospital of Kunming University of Science and Technology, The First People's Hospital of Yunnan Province, Kunming, Yunnan 650100, P.R. China
| |
Collapse
|
3
|
Muacevic A, Adler JR, Dufrene K, Mclean W, Ramesh P, Talbot N, Saad Aldine A, Arevalo O. Adrenal Ganglioneuroblastoma of Adult Onset: A Literature Review. Cureus 2023; 15:e33288. [PMID: 36751157 PMCID: PMC9897232 DOI: 10.7759/cureus.33288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/03/2023] [Indexed: 01/04/2023] Open
Abstract
Ganglioneuroblastomas (GNBs) are a rare subtype of neoplastic tumors that arise from the autonomic nervous system and contain both mature gangliocytes and immature neuroblasts. The primary age group affected by GNBs is the pediatric population, with less than 50 cases of adult GNBs existing in the literature. To the authors' best knowledge, only 21 cases of GNBs arising in the adrenal glands of adults have been reported. Herein we present a literature review examining the symptoms, treatment type, age, and sex of adults, and the presence of tumor metastases and calcification from the 21 cases reported in the literature.
Collapse
|
4
|
Passudetti V, De Leo L, Maselli F, Pellegrino R, Brindisino F. Tumour Hidden behind Thoracic Spine Pain: A Rare Case of Neuroblastoma in a Young Mother-A Case Report. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13448. [PMID: 36294024 PMCID: PMC9602929 DOI: 10.3390/ijerph192013448] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/03/2022] [Revised: 10/14/2022] [Accepted: 10/16/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Neuroblastoma (NB) is the most common form of paediatric malignancy, responsible for up to 15% of cancer deaths in children, whereas in adults, its onset is a rarer event, despite being characterized by greater lethality. The purpose of this case report was to describe the clinical presentation, physical examination, and clinical decision-making process in a patient with Neuroblastoma mimicking thoracic spine pain of musculoskeletal origin. METHODS a thirty-two-year-old mother complained of thoracic spine pain on her left vertebral side and in her left periscapular muscles; her pain was constant, deep, and worse at night; she also experienced pain during physical exertion of her upper limbs; the patient also reported pain in her left breast. RESULTS the physiotherapist's anamnesis and physical examination led him to suspect the need for an extra-expertise pathology and to refer his patient to another medical specialist; the subsequent investigations revealed a poorly differentiated Neuroblastoma ALK + (IIC) in the posterior mediastinum on the left; the patient underwent surgery excision after 4 months. CONCLUSIONS differential screening should be a physiotherapist's fundamental skill in their patients' clinical management, especially in direct access cases; the physiotherapist has an ethical and moral duty to conduct differential screening, in order to rule out extra-expertise pathologies-both when patients self-refer for rehabilitation assessment, and when they are referred by other practitioners.
Collapse
Affiliation(s)
- Valerio Passudetti
- Department of Clinical Sciences and Translational Medicine, Medicine and Surgery School, University of Roma “Tor Vergata”, 00133 Rome, Italy
| | - Luca De Leo
- Check-Up Center Private Practice, 73020 Lecce, Italy
| | - Filippo Maselli
- Department of Human Neurosciences, University of Roma “Sapienza”, 00185 Rome, Italy
- Sovrintendenza Sanitaria Regionale Puglia INAIL, 70126 Bari, Italy
| | - Raffaello Pellegrino
- Antalgic Mini-Invasive and Rehab-Outpatients Unit, Department of Medicine and Science of Aging, University “G. d’Annunzio” Chieti-Pescara, 66100 Chieti, Italy or
| | - Fabrizio Brindisino
- Department of Medicine and Health Science “Vincenzo Tiberio”, University of Molise C/da Tappino c/o Cardarelli Hospital, 86100 Campobasso, Italy
| |
Collapse
|
5
|
Vassallo L, Fasciano M, Baralis I, Pellegrino L, Fortunato M, Orcioni GF, Sorrentino S. A rare case of adrenal ganglioneuroblastoma-intermixed in an adult and a review of literature. Radiol Case Rep 2021; 16:2351-2356. [PMID: 34306280 PMCID: PMC8258789 DOI: 10.1016/j.radcr.2021.06.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2021] [Revised: 06/03/2021] [Accepted: 06/03/2021] [Indexed: 11/04/2022] Open
Abstract
Peripheral neuroblastic tumors are extremely rare in the adult with less just over 20 cases involving adrenal gland described in the literature. We reported herewith the case of a 22-year-old young male who presented with epigastric pain and diarrhea. Imaging studies documented a 3.5cm x 3cm x 4cm solid well-circumscribed right adrenal mass, of heterogeneous structure and with fine calcifications. The lesion turned negative at MIBG scintigraphy. A right robotic-assisted adrenalectomy was performed leading to complete excision of the lesion without complications. Histology was consistent with intermixed stroma-rich ganglioneuroblastoma. A wait-and-see strategy was considered adequate. Two years after diagnosis patient is alive disease-free. Although the definitive diagnosis of a peripheral neuroblastic tumor is obtained after histopathological analysis, CT, and MRI are helpful to further characterize masses and useful in pretreatment risk stratification. Clinicians should be aware of the possibility of GNB development in adult population and its malignant potential.
Collapse
Key Words
- ADC, Apparent Diffusion Coefficient
- Adrenal gland
- Adult
- CT, Computed Tomography
- Computed tomography
- GN, Ganglioneuroma
- GNB, Ganglioneuroblastoma
- Ganglioneuroblastoma
- INPC, International Neuroblastoma Pathology Classification
- INRG, International Neuroblastoma Risk Group
- INSS, International Neuroblastoma Staging System
- MRI, Magnetic Resonance Imaging
- Magnetic resonance imaging
- NB, Neuroblastoma
- Neuroblastoma
- PNT, Neuroblastic tumors
- RT, Radiotherapy
- US, Ultrasound
Collapse
Affiliation(s)
- Lorenzo Vassallo
- Unit of Radiology, S.S. Annunziata Hospital, ASLCN1, Via degli Ospedali 9, 12038, Cuneo, Italy
| | - Mirella Fasciano
- Unit of Radiology, S.S. Annunziata Hospital, ASLCN1, Via degli Ospedali 9, 12038, Cuneo, Italy
| | - Ilaria Baralis
- Department of Diagnostic and Interventional Radiology, S. Croce e Carle Hospital, Via Michele Coppino 26, 12100, Cuneo, Italy
| | - Luca Pellegrino
- General and Oncologic Surgery Unit, Department of Surgery, Santa Croce e Carle Hospital, Via Michele Coppino 26, 12100, Cuneo, Italy
| | - Mirella Fortunato
- Department of Pathology, Santa Croce e Carle Hospital, Via Michele Coppino 26, 12100, Cuneo, Italy
| | | | - Stefania Sorrentino
- Unit of Pediatric Oncology, IRCCS Istituto Giannina Gaslini, Via Gerolamo Gaslini 5, 16147 Genoa, Italy
| |
Collapse
|
6
|
Duan K, Dickson BC, Marrano P, Thorner PS, Chung CT. Adult‐onset neuroblastoma: Report of seven cases with molecular genetic characterization. Genes Chromosomes Cancer 2019; 59:240-248. [DOI: 10.1002/gcc.22826] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Revised: 11/13/2019] [Accepted: 11/19/2019] [Indexed: 01/10/2023] Open
Affiliation(s)
- Kai Duan
- Department of Laboratory Medicine and Pathobiology University of Toronto Toronto Ontario Canada
| | - Brendan C. Dickson
- Department of Laboratory Medicine and Pathobiology University of Toronto Toronto Ontario Canada
- Department of Pathology and Laboratory Medicine Mount Sinai Hospital Toronto Ontario Canada
| | - Paula Marrano
- Division of Pathology The Hospital for Sick Children Toronto Ontario Canada
| | - Paul S. Thorner
- Department of Laboratory Medicine and Pathobiology University of Toronto Toronto Ontario Canada
- Division of Pathology The Hospital for Sick Children Toronto Ontario Canada
| | - Catherine T. Chung
- Department of Laboratory Medicine and Pathobiology University of Toronto Toronto Ontario Canada
- Division of Pathology The Hospital for Sick Children Toronto Ontario Canada
| |
Collapse
|
7
|
Risum S, Knigge U, Langer SW. Hitherto unseen survival in an ALK-positive-patient with advanced stage adult ganglioneuroblastoma treated with personalized medicine. Clin Case Rep 2017; 5:2085-2087. [PMID: 29225862 PMCID: PMC5715430 DOI: 10.1002/ccr3.1262] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2016] [Revised: 07/28/2017] [Accepted: 08/07/2017] [Indexed: 02/02/2023] Open
Abstract
Survival of stage 4 ganglioneuroblastoma (GNB) patients is poor; no reports exist of patients surviving up to 5 years (1, 2). We report the clinical and therapeutic course of a patient with stage 4 GNB surviving beyond expectations due to a multimodal treatment approach incorporating new technologies in cancer diagnostic and treatment.
Collapse
Affiliation(s)
- Signe Risum
- Department of Oncology ENETS Neuroendocrine Tumor Centre of Excellence Rigshospitalet, Copenhagen University Hospital Copenhagen DK-2100 Denmark
| | - Ulrich Knigge
- Department of Endocrinology ENETS Neuroendocrine Tumor Centre of Excellence Rigshospitalet, Copenhagen University Hospital Copenhagen DK-2100 Denmark
| | - Seppo W Langer
- Department of Oncology ENETS Neuroendocrine Tumor Centre of Excellence Rigshospitalet, Copenhagen University Hospital Copenhagen DK-2100 Denmark
| |
Collapse
|
8
|
Whittle SB, Smith V, Doherty E, Zhao S, McCarty S, Zage PE. Overview and recent advances in the treatment of neuroblastoma. Expert Rev Anticancer Ther 2017; 17:369-386. [PMID: 28142287 DOI: 10.1080/14737140.2017.1285230] [Citation(s) in RCA: 242] [Impact Index Per Article: 34.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
INTRODUCTION Children with neuroblastoma have widely divergent outcomes, ranging from cure in >90% of patients with low risk disease to <50% for those with high risk disease. Recent research has shed light on the biology of neuroblastoma, allowing for more accurate risk stratification and treatment reduction in many cases, although newer treatment strategies for children with high-risk and relapsed neuroblastoma are needed to improve outcomes. Areas covered: Neuroblastoma epidemiology, diagnosis, risk stratification, and recent advances in treatment of both newly diagnosed and relapsed neuroblastoma. Expert commentary: The identification of newer tumor targets and of novel cell-mediated immunotherapy agents may lead to novel therapeutic approaches, and clinical trials for regimens designed to target individual genetic aberrations in tumors are underway. A combination of therapeutic modalities will likely be required to improve survival and cure rates for patients with high-risk neuroblastoma.
Collapse
Affiliation(s)
- Sarah B Whittle
- a Department of Pediatrics, Section of Hematology-Oncology , Texas Children's Cancer and Hematology Centers, Baylor College of Medicine , Houston , TX , USA
| | - Valeria Smith
- a Department of Pediatrics, Section of Hematology-Oncology , Texas Children's Cancer and Hematology Centers, Baylor College of Medicine , Houston , TX , USA
| | - Erin Doherty
- a Department of Pediatrics, Section of Hematology-Oncology , Texas Children's Cancer and Hematology Centers, Baylor College of Medicine , Houston , TX , USA
| | - Sibo Zhao
- a Department of Pediatrics, Section of Hematology-Oncology , Texas Children's Cancer and Hematology Centers, Baylor College of Medicine , Houston , TX , USA
| | - Scott McCarty
- b Department of Pediatrics, Division of Hematology-Oncology , University of California San Diego, La Jolla, CA and Peckham Center for Cancer and Blood Disorders, Rady Children's Hospital , San Diego , CA , USA
| | - Peter E Zage
- b Department of Pediatrics, Division of Hematology-Oncology , University of California San Diego, La Jolla, CA and Peckham Center for Cancer and Blood Disorders, Rady Children's Hospital , San Diego , CA , USA
| |
Collapse
|
9
|
Luksch R, Castellani MR, Collini P, De Bernardi B, Conte M, Gambini C, Gandola L, Garaventa A, Biasoni D, Podda M, Sementa AR, Gatta G, Tonini GP. Neuroblastoma (Peripheral neuroblastic tumours). Crit Rev Oncol Hematol 2016; 107:163-181. [PMID: 27823645 DOI: 10.1016/j.critrevonc.2016.10.001] [Citation(s) in RCA: 69] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2015] [Revised: 09/05/2016] [Accepted: 10/03/2016] [Indexed: 02/07/2023] Open
Abstract
Peripheral neuroblastic tumours (PNTs), a family of tumours arising in the embryonal remnants of the sympathetic nervous system, account for 7-10% of all tumours in children. In two-thirds of cases, PNTs originate in the adrenal glands or the retroperitoneal ganglia. At least one third present metastases at onset, with bone and bone marrow being the most frequent metastatic sites. Disease extension, MYCN oncogene status and age are the most relevant prognostic factors, and their influence on outcome have been considered in the design of the recent treatment protocols. Consequently, the probability of cure has increased significantly in the last two decades. In children with localised operable disease, surgical resection alone is usually a sufficient treatment, with 3-year event-free survival (EFS) being greater than 85%. For locally advanced disease, primary chemotherapy followed by surgery and/or radiotherapy yields an EFS of around 75%. The greatest problem is posed by children with metastatic disease or amplified MYCN gene, who continue to do badly despite intensive treatments. Ongoing trials are exploring the efficacy of new drugs and novel immunological approaches in order to save a greater number of these patients.
Collapse
Affiliation(s)
- Roberto Luksch
- Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.
| | | | - Paola Collini
- Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | | | - Massimo Conte
- Giannina Gaslini Children's Research Hospital, Genoa, Italy
| | | | - Lorenza Gandola
- Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | | | - Davide Biasoni
- Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Marta Podda
- Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | | | - Gemma Gatta
- Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Gian Paolo Tonini
- Neuroblastoma Laboratory, Paediatric Research Institute, Padua, Italy
| |
Collapse
|