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Hernandez Tejada F, Yedururi S, Kumar R, Stewart J, Tarek N. Ganglioneuroma with Disseminated Bone Lesions. Pediatr Blood Cancer 2017; 64. [PMID: 28221728 DOI: 10.1002/pbc.26298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2016] [Revised: 08/31/2016] [Accepted: 09/01/2016] [Indexed: 11/11/2022]
Affiliation(s)
| | - Sireesha Yedururi
- Department of Diagnostic Radiology, University of Texas MD Anderson Cancer Center, Texas, Houston
| | - Rajendra Kumar
- Department of Diagnostic Radiology, University of Texas MD Anderson Cancer Center, Texas, Houston
| | - John Stewart
- Department of Pathology, University of Texas MD Anderson Cancer Center, Texas, Houston
| | - Nidale Tarek
- Department of Pediatrics, University of Texas MD Anderson Cancer Center, Texas, Houston.,Department of Pediatrics and Adolescent Medicine, Children's Cancer Institute, American University of Beirut Medical Center, Beirut, Lebanon
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Park SH, Kim S, Park CJ, Jang S, Chi HS, Koh KN, Im HJ, Seo JJ. Presence of differentiating neuroblasts in bone marrow is a favorable prognostic factor for bone marrow metastatic neuroblastoma at diagnosis. Ann Lab Med 2013; 33:89-96. [PMID: 23483759 PMCID: PMC3589646 DOI: 10.3343/alm.2013.33.2.89] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2012] [Revised: 11/06/2012] [Accepted: 01/14/2013] [Indexed: 12/02/2022] Open
Abstract
Background The prognostic impact of the presence of differentiating neuroblasts in bone marrow (BM) remains unclear in BM metastatic neuroblastoma (NB). We aimed to identify the prognostic impact of differentiating neuroblasts in BM at diagnosis and after chemotherapy. Methods A total of 51 patients diagnosed with BM metastatic NB at Asan Medical Center between January 1990 and July 2005 were enrolled. BM histology and laboratory data along with overall survival (OS) were compared with regard to the differentiation status of neuroblasts in BM at diagnosis and after chemotherapy. Results Among the 51 patients, 13 (25.5%) exhibited differentiating neuroblasts in BM at diagnosis and 17/51 (33.3%) exhibited them after chemotherapy. The only significant difference among patient groups was the improved OS in patients with differentiated neuroblasts in BM at diagnosis (P=0.021). In contrast, the differentiation status of neuroblasts in BM after chemotherapy did not affect OS (P=0.852). Conclusions Our study is the first report describing the presence of differentiating neuroblasts in BM. The presence of differentiating neuroblasts in BM at diagnosis may be a favorable prognostic factor for patients with BM metastatic NB; however, the same phenomenon after chemotherapy is irrelevant to prognosis.
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Affiliation(s)
- Sang Hyuk Park
- Department of Laboratory Medicine, University of Ulsan College of Medicine and Asan Medical Center, Seoul, Korea
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Hero B, Simon T, Spitz R, Ernestus K, Gnekow AK, Scheel-Walter HG, Schwabe D, Schilling FH, Benz-Bohm G, Berthold F. Localized infant neuroblastomas often show spontaneous regression: results of the prospective trials NB95-S and NB97. J Clin Oncol 2008; 26:1504-10. [PMID: 18349403 DOI: 10.1200/jco.2007.12.3349] [Citation(s) in RCA: 186] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
PURPOSE The excellent prognosis of localized neuroblastoma in infants, the overdiagnosis observed in neuroblastoma screening studies, and several case reports of regression of localized neuroblastoma prompted us to initiate a prospective cooperative trial on observation of localized neuroblastoma without cytotoxic treatment. PATIENTS AND METHODS For infants with localized neuroblastoma without MYCN amplification, chemotherapy was scheduled only in cases with threatening symptoms; otherwise, the tumor was either resected or observed by ultrasound and magnetic resonance imaging (MRI). RESULTS Of 340 eligible participants, 190 underwent resection, 57 were treated with chemotherapy, and 93 were observed with gross residual tumor. Of those 93 patients with unresected tumors, spontaneous regression was seen in 44, local progression in 28, progression to stage 4S in seven, and progression to stage 4 in four. Time to regression was quite variable, with first signs of regression noted 1 to 18 months after diagnosis and in 15 of 44 patients even after the first year of life. So far, complete regression was observed in 17 of 44 patients 4 to 20 months after diagnosis. Known clinical risk factors were not able to differentiate between patients with regression and regional or metastatic progression. Overall survival (OS; 3-year OS, 0.99 +/- 0.01) and metastases-free survival (rate at 3 years, 0.94 +/- 0.03) for patients with unresected tumors was excellent and was not different from patients treated with surgery or chemotherapy. CONCLUSION Spontaneous regression is regularly seen in infants with localized neuroblastoma and is not limited to the first year of life. A wait-and-see strategy is justified in those patients.
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Affiliation(s)
- Barbara Hero
- Children's Hospital, Department of Pediatric Oncology and Hematology, University of Cologne, Kerpener Str. 62, 50924 Cologne, Germany.
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Nishio N, Mimaya JI, Horikoshi Y, Okada N, Nara T, Takashima Y, Urushihara N, Hasegawa S, Aoki K, Hamasaki M. Spontaneous regression of metastases including meningeal metastasis after gross resection of primary tumor in an infant with stage 4 neuroblastoma. J Pediatr Hematol Oncol 2006; 28:537-9. [PMID: 16912596 DOI: 10.1097/01.mph.0000212970.06125.8e] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Neuroblastoma is the most common extracranial solid tumor in childhood. Spontaneous regression has been well described in infants, especially in those with stage 4S and those with low-stage neuroblastoma detected by screening. However, neuroblastoma presenting with intracranial metastasis is generally considered to need a postoperative chemotherapy. Here, we report a 3-month-old girl with stage 4 neuroblastoma presenting with spontaneous regression of metastatic tumor including meningeal metastasis after gross resection of primary tumor. Further investigation may be required to detect patients of this kind without the need of postoperative chemotherapy regardless of their stage at diagnosis.
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Affiliation(s)
- Nobuhiro Nishio
- Department of Hematology/Oncology, Shizuoka Children's Hospital, Shizuoka, Japan
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Abstract
Neuroblastoma is the most frequently occurring solid tumour in children, with an incidence of 1.3 cases per 100000 children aged 0-14 years. Despite many advances during the past three decades, neuroblastoma has remained an enigmatic challenge to clinical and basic scientists. 20 years ago, the MYCN gene was found to be amplified in neuroblastomas, and research since then has focused on the search for other genetic markers. It has emerged that neuroblastoma cells, like cells of many other tumour types, often suffer from extensive, non-random genetic damage at multiple genetic loci. Elucidation of the exact molecular make-up of neuroblastomas will enable researchers to analyse how much specific markers, alone or in combination, can help to stratify disease in prospective studies; at present, stratification is based on age, stage, MYCN, and Shimada pathology. Neuroblastoma may be one of the first examples of the use of genetic tumour markers as a tool for defining tumour behaviour and to aid clinical staging.
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Abstract
Neuroblastoma is a malignant childhood tumor of migrating neuroectodermal cells derived from the neural crest and destined for the adrenal medulla and the sympathetic nervous system. The biological behavior of neuroblastomas is extremely variable and in some respects unique. Neuroblastomas tend to regress spontaneously in a portion of infants or to differentiate into a benign ganglioneuroma in some older patients. Unfortunately, in the majority of patients neuroblastoma is metastatic at the time of diagnosis, and it usually undergoes rapid progression with a fatal outcome. The mechanisms leading to this diverse clinical behavior of neuroblastomas are largely unclear. From the analysis of tumors at the cytogenetic and molecular level non-random genetic changes have been identified, including ploidy changes, amplification of the oncogene MYCN, deletions of chromosome 1p, gains of chromosome arm 17q, and deletions of 11q as well as of other genomic regions that allow tumors to be classified into subsets with distinct biological features and clinical behavior. MYCN status is widely accepted for therapy stratification. Additional genetic parameters are currently under investigation to refine risk assessment, but so far the molecular monitoring tools for prediction of therapy response and disease outcome are still incomplete. This should lead to more risk-adapted therapies according to the clinical-genetic parameters by which individual tumors are characterized. This review aims at discussing the role of genomic changes in neuroblastomas of diverse biological and clinical types.
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Affiliation(s)
- Frank Westermann
- Department of Cytogenetics (H0400), German Cancer Research Center, Im Neuenheimer Feld 280, 69120 Heidelberg, Germany.
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Abstract
Neuroblastoma is predominantly a paediatric neoplasm of the sympathetic nervous system. Despite the aggressive nature of the disease, spontaneous regression is frequently observed in infants diagnosed under the age of 12 months; especially with a specific stage referred to as stage 4s. Discovering the conditions, the elements, the mechanism and the indices behind this regression phenomenon could have therapeutic potential for prevention and cure. A review of the literature has implicated adrenocorticotropin hormone in both the aetiology and spontaneous regression of neuroblastoma. Manipulation of adrenocorticotropin hormone may offer hope for prevention and cure. Ingestible products such as retinoic acid, glycyrrhizic acid, salsolinol and ketoconazole acting in concert, could represent instrumental tools in a therapeutic manipulation process.
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Affiliation(s)
- Graeme R Tucker
- The Lighthouse Laboratories, 8 Painter Crescent, Mundaring, Western Australia 6073, Australia.
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Abstract
This article summarizes several malignant childhood neoplasms and benign tumors that can mimic malignancies. Because malignant skin tumors are rare in children, parents and physicians often are not sufficiently suspicious to ensure that an early diagnosis can be made. Many malignant skin tumors have features that suggest a vascular or hemangioma-like lesion. Because hemangiomas occur in 10% of infants, it is often considered prudent to adopt a wait-and-see attitude; however, if the lesion is too firm to be a hemangioma or its growth pattern does not follow that of a typical hemangioma, additional options should be considered. To manage childhood skin malignancies, one needs expert consultation, early biopsy, and correct histopathologic interpretation.
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Affiliation(s)
- A J Wyatt
- Department of Medicine (Dermatology), University of Arizona College of Medicine, Tucson, USA
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Frank DK, Ramaswamy G, Tavin E, Moscatello AL. Poorly differentiated pediatric head and neck neuroblastoma: a diagnostic dilemma. Int J Pediatr Otorhinolaryngol 1995; 33:103-11. [PMID: 7499043 DOI: 10.1016/0165-5876(95)01194-g] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Primary pediatric head and neck neuroblastoma is rare, with metastatic disease being the more common mode of involvement in this anatomic region. Poorly differentiated neuroblastoma initially presenting in head and neck locations presents a diagnostic dilemma, especially when evidence of primary disease in typical abdominal, retroperitoneal and thoracic sites is lacking. This tumor cannot easily be distinguished from the other common pediatric small round cell malignancies that may originate in or metastasize to the head and neck. Recent years have seen great strides in the immunohistochemical as well as cytogenetic characterization of certain pediatric small round cell lesions. A never before reported solitary, poorly differentiated neuroblastoma of the right parotid gland in a 20-month-old female is presented in order to familiarize the otolaryngologist with the modern diagnostic armamentarium available for the accurate characterization, and thus appropriate workup and treatment of this disease.
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Affiliation(s)
- D K Frank
- Department of Otolaryngology-Head and Neck Surgery, New York Eye and Ear Infirmary, New York City 10003, USA
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Affiliation(s)
- R Knight
- Department of Cystic Fibrosis, National Heart and Lung Institute, London, UK
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Maher-Wiese VL, Wenner NP, Grant-Kels JM. Metastatic cutaneous lesions in children and adolescents with a case report of metastatic neuroblastoma. J Am Acad Dermatol 1992; 26:620-8. [PMID: 1597549 DOI: 10.1016/0190-9622(92)70091-s] [Citation(s) in RCA: 26] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
A child with neuroblastoma metastatic to the skin is reported. A review of the literature revealed that neuroblastoma and leukemia are the neoplasms most frequently associated with cutaneous metastases in children and adolescents. The low incidence of these lesions and their high malignant potential are two important factors that emphasize the pivotal role the dermatologist plays in prompt diagnosis and early referral.
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Affiliation(s)
- V L Maher-Wiese
- Department of Dermatology, Brown University, Providence, Rhode Island
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Cervera A, Kingston JE, Malpas JS. Late recurrence of neuroblastoma: a report of five cases and review of the literature. Pediatr Hematol Oncol 1990; 7:311-22. [PMID: 2268531 DOI: 10.3109/08880019009033408] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Late recurrence of neuroblastoma is uncommon. We report five patients who developed recurrent disease more than five years after diagnosis and review the literature on this subject.
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Affiliation(s)
- A Cervera
- Department of Paediatric Oncology, St. Bartholomew's Hospital, London
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Abstract
A metastatic neuroblastoma arose in a posterior mediastinal tumor that had been present for at least 52 years. The diagnosis of neuroblastoma was first made when the patient was 81 years of age from biopsy of a metastatic lesion to the femur and later from biopsy of the mediastinal mass.
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Affiliation(s)
- R Mir
- Department of Laboratory Medicine, Long Island Jewish Medical Center, New Hyde Park, NY 11042
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Abstract
Neuroblastoma originates in the adrenal medulla or anywhere in the body that sympathetic tissue normally is present. It may present with a variety of symptoms due to primary tumor, metastatic disease, or unusual signs and symptoms such as opsoclonus-myoclonus or severe diarrhea. Despite the fact that this neoplasm responds to a variety of therapeutic modalities, it remains one of the most frustrating and difficult childhood tumors to treat and cure.
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