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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.
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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
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Rendón Mejía NA, Ávila Quiñones II, Preciado Hernández JA, García Castillo KD. Retroperitoneal adrenal neuroblastoma with bone marrow metastatic activity in a young adult. Urol Case Rep 2024; 55:102759. [PMID: 38846926 PMCID: PMC11153926 DOI: 10.1016/j.eucr.2024.102759] [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: 04/15/2024] [Revised: 05/17/2024] [Accepted: 05/21/2024] [Indexed: 06/09/2024] Open
Abstract
A 31-year-old male came to emergency department with acute abdominal pain from the right flank, diaphoresis and, palpitations. Contrasted abdominal CT revealed a tumor dependent from right adrenal gland and kidney. A laparoscopic radical nephrectomy was made to resect the tumor and pain relief. Pathological analysis reported poorly differentiated neuroblastoma from the right adrenal gland without involvement to kidney and ureter. The patient was sent to oncology clinic to continue with chemotherapy treatment. This is the third case of adult neuroblastoma reported in South America. Adult neuroblastoma is an uncommon cause of malignant neoplasm with an exceptional incidence reported.
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Affiliation(s)
- Norman Alejandro Rendón Mejía
- Department of Surgery, Hospital General Salvador Zubirán Anchondo, Universidad Autónoma de Chihuahua, Chihuahua, Mexico
| | - Iram Ivey Ávila Quiñones
- Department of Urology, Hospital Central Universitario Dr. Enrique Grajeda Herrera, Chihuahua, Mexico
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Cheung SYA, Hay JL, Lin YW, de Greef R, Bullock J. Pediatric oncology drug development and dosage optimization. Front Oncol 2024; 13:1235947. [PMID: 38348118 PMCID: PMC10860405 DOI: 10.3389/fonc.2023.1235947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Accepted: 12/29/2023] [Indexed: 02/15/2024] Open
Abstract
Oncology drug discovery and development has always been an area facing many challenges. Phase 1 oncology studies are typically small, open-label, sequential studies enrolling a small sample of adult patients (i.e., 3-6 patients/cohort) in dose escalation. Pediatric evaluations typically lag behind the adult development program. The pediatric starting dose is traditionally referenced on the recommended phase 2 dose in adults with the incorporation of body size scaling. The size of the study is also small and dependent upon the prevalence of the disease in the pediatric population. Similar to adult development, the dose is escalated or de-escalated until reaching the maximum tolerated dose (MTD) that also provides desired biological activities or efficacy. The escalation steps and identification of MTD are often rule-based and do not incorporate all the available information, such as pharmacokinetic (PK), pharmacodynamic (PD), tolerability and efficacy data. Therefore, it is doubtful if the MTD approach is optimal to determine the dosage. Hence, it is important to evaluate whether there is an optimal dosage below the MTD, especially considering the emerging complexity of combination therapies and the long-term tolerability and safety of the treatments. Identification of an optimal dosage is also vital not only for adult patients but for pediatric populations as well. Dosage-finding is much more challenging for pediatric populations due to the limited patient population and differences among the pediatric age range in terms of maturation and ontogeny that could impact PK. Many sponsors defer the pediatric strategy as they are often perplexed by the challenges presented by pediatric oncology drug development (model of action relevancy to pediatric population, budget, timeline and regulatory requirements). This leads to a limited number of approved drugs for pediatric oncology patients. This review article provides the current regulatory landscape, incentives and how they impact pediatric drug discovery and development. We also consider different pediatric cancers and potential clinical trial challenges/opportunities when designing pediatric clinical trials. An outline of how quantitative methods such as pharmacometrics/modelling & simulation can support the dosage-finding and justification is also included. Finally, we provide some reflections that we consider helpful to accelerate pediatric drug discovery and development.
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Dharmalingam P, Chenniappan AD, Alashetty S, Bidadi Lingappa K, Patil Okaly GV. Neuroblastoma in uncommon age group - A case series diagnosed on cytology. Diagn Cytopathol 2023; 51:629-635. [PMID: 37326472 DOI: 10.1002/dc.25189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Revised: 06/05/2023] [Accepted: 06/09/2023] [Indexed: 06/17/2023]
Abstract
BACKGROUND Neuroblastoma is the most common extracranial malignant neoplasm in early childhood. It is rare in the adult population. AIMS AND OBJECTIVES We aimed to study the incidence of neuroblastoma in the uncommon age group diagnosed on cytology. MATERIALS AND METHODS A prospective descriptive study spanning 2 years from December 2020 to January 2022 was done, in which neuroblastoma cases diagnosed by Fine needle aspiration cytology aged >12 years were collected. The clinical, cytomorphological and immunohistochemical findings were studied. Histopathological correlation was done wherever available. RESULTS We identified three cases of neuroblastoma during this period. Two cases were middle-aged adults, and one was an adolescent. All cases presented with abdominal masses and revealed small round cell tumor on cytology. Two cases fell into undifferentiated category and one case fell into the poorly differentiated subtype. All cases were positive for neuroendocrine markers. Histopathological correlation was available in two cases. MYC N amplification was absent in all cases. CONCLUSION It differs from pediatric neuroblastoma due to the lack of classical histomorphological features and molecular alterations. Adult-onset neuroblastomas carry a worse prognosis than childhood tumors.
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Affiliation(s)
- Priya Dharmalingam
- Department of Pathology, Kidwai Memorial Institute of Oncology, Bengaluru, India
| | | | - Soumya Alashetty
- Department of Pathology, Kidwai Memorial Institute of Oncology, Bengaluru, India
| | | | - Geeta V Patil Okaly
- Department of Pathology, Kidwai Memorial Institute of Oncology, Bengaluru, India
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Jiang Q, Gao H, Gao G, Li Y, Cheng H, Shi G, Shang A. Neuroblastoma of the lumbosacral canal in an adult: a case report and literature review. Front Neurol 2023; 14:1195664. [PMID: 37602246 PMCID: PMC10435846 DOI: 10.3389/fneur.2023.1195664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Accepted: 07/21/2023] [Indexed: 08/22/2023] Open
Abstract
Neuroblastoma (NB) is a leading cause of death in children. It usually occurs in the adrenal gland and rarely in the spinal canal. Here, we report the case of a 48-year-old male patient with abnormal thickening of the cauda equina nerve as revealed by lumbosacral magnetic resonance imaging. The patient's main clinical manifestations were numbness and pain in both lower limbs. The patient underwent surgical treatment; however, intraoperatively, an unclear border was observed between the cauda equina nerve and the tumor; therefore, the tumor was not forcibly excised. The postoperative pathological results were reported as NB. The disease known as NB, which is extremely rare. We believe that a pathological biopsy is extremely vital for diagnosing NB, and aggressive post-operative radio-chemotherapy could potentially prolong the patient's survival time.
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Affiliation(s)
| | - Haihao Gao
- Chinese PLA Medical School, Beijing, China
| | - Gan Gao
- Chinese PLA Medical School, Beijing, China
| | - Yang Li
- Department of Critical Care Medicine, Chinese PAP Beijing Corps Hospital, Beijing, China
| | | | | | - Aijia Shang
- Department of Neurosurgery, Chinese PLA General Hospital, Beijing, China
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Lin YW, Hsu YH, Lee MY. Adult Patient With Neuroblastoma Presenting as Acute Leukemia. Cureus 2022; 14:e27769. [PMID: 36106239 PMCID: PMC9449338 DOI: 10.7759/cureus.27769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/08/2022] [Indexed: 11/08/2022] Open
Abstract
Neuroblastoma (NB) is the most common extra-cranial cancer of early childhood and rarely occurs in adults. The clinical symptoms of NB can be diverse. We discuss a rare case of an adult NB presenting as acute leukemia. A 45-year-old woman presented with persistent hip pain, weight loss, anemia, and incidental fever for several months. Imaging studies showed diffuse bone marrow (BM) uptake and hypermetabolic lesions involving the left adrenal gland, bilateral axillary nodes, and left lateral aspect of the abdomen. Her 24-hour urine catecholamines were within the normal range. On the peripheral blood film, blast-like cells were noted, occupying approximately 2% of leukocytes. The BM imprints showed infiltration of blast-like cells with convoluted nuclei and scant cytoplasm in more than 85% of the total nucleated cells. Acute leukemia was initially suspected based on morphology. Blast-like cells were negative for myeloperoxidase, combined esterase, periodic acid-Schiff, CD45RB, CD68, and CD138. In a further study, these cells were positive for CD56, synaptophysin (SYN), and CD99 with negativity for desmin, myogenin, NKX-2.2, CD31, cytokeratin (AE1/AE3), Melan-A, ERG, S-100, and SALL4. Morphologically similar neoplastic cells in axillary node biopsy were positive for CD56, chromogranin A, SYN, and neurofilament, but negative for GFAP, CD246, and vimentin. Based on laboratory, pathological, and imaging studies, metastatic NB with BM and multifocal involvement was diagnosed. The differential diagnosis of metastatic small blue round cell tumors should be considered for adult patients with circulating blast-like cells, and an accurate diagnosis would enable the patient to receive appropriate and timely treatment.
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Deslarzes P, Djafarrian R, Matter M, La Rosa S, Gengler C, Beck-Popovic M, Zingg T. Neuroblastic Tumors of the Adrenal Gland in Elderly Patients: A Case Report and Review of the Literature. Front Pediatr 2022; 10:869518. [PMID: 35656383 PMCID: PMC9152181 DOI: 10.3389/fped.2022.869518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Accepted: 04/20/2022] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Neuroblastic neoplasms (NN) include ganglioneuromas (GN), ganglioneuroblastomas (GNB), and neuroblastomas (NB). They generally arise in childhood from primitive sympathetic ganglion cells. Their incidence in adults, especially among elderly, is extremely low. CASE PRESENTATION This is the case of a 74-year-old woman with history of abdominal pain, weakness and night sweating since several months. Blood pressure was normal. CT-scan showed a 10 cm left adrenal mass, without other pathologic findings. An open left-sided adrenalectomy was performed. Recovery was uneventful with hospital length of stay of 8 days. Based on morphological, immunohistochemical, and molecular features the diagnosis was a nodular GNB. A positron emission tomography (PET) performed 6 weeks after the resection did not show any residual tumor or distant metastases. The patient was followed-up with annual clinical and radiological exams. CONCLUSION This case presentation, associated with a review of the literature, illustrates the importance to include NN in the preoperative differential diagnosis of adrenal tumors in adults and highlights the need for multidisciplinary patient work-up and management.
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Affiliation(s)
- Philip Deslarzes
- Department of Visceral Surgery, Lausanne University Hospital, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland
| | - Reza Djafarrian
- Department of Visceral Surgery, Lausanne University Hospital, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland
| | - Maurice Matter
- Department of Visceral Surgery, Lausanne University Hospital, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland
| | - Stefano La Rosa
- Department of Pathology, Institute of Pathology, Lausanne University Hospital, Lausanne, Switzerland
| | - Carole Gengler
- Department of Pathology, Institute of Pathology, Lausanne University Hospital, Lausanne, Switzerland
| | - Maja Beck-Popovic
- Department "Woman-Mother-Child", Lausanne University Hospital, Lausanne, Switzerland
| | - Tobias Zingg
- Department of Visceral Surgery, Lausanne University Hospital, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland
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Chen YL, Zhang ZM, Li XL, Tao YF, Wu SY, Fang F, Xie Y, Liao XM, Li G, Wu D, Wang HR, Zuo R, Cao HB, Pan JJ, Yu JJ, Zhang Z, Chu XR, Zhang YP, Feng CX, Wang JW, Lu J, Hu SY, Li ZH, Pan J. MI-773, a breaker of the MDM2/p53 axis, exhibits anticancer effects in neuroblastoma via downregulation of INSM1. Oncol Lett 2021; 22:838. [PMID: 34712362 DOI: 10.3892/ol.2021.13099] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Accepted: 08/13/2021] [Indexed: 12/15/2022] Open
Abstract
Neuroblastoma (NB) is a common pediatric malignancy associated with poor outcomes. Recent studies have shown that murine double minute2 homolog (MDM2) protein inhibitors are promising anticancer agents. MI-773 is a novel and specific antagonist of MDM2, however, the molecular mechanism of its anti-NB activity remains unclear. NB cell viability was measured by Cell Counting Kit-8 assay following MI-773 treatment. Cell cycle progression was analyzed using PI staining and apoptosis was assessed using Annexin V/PI staining. The molecular mechanisms by which MI-773 exerted its effects were investigated using a microarray. The results showed that disturbance of the MDM2/p53 axis by MI-773 resulted in potent suppression of proliferation, induction of apoptosis and cell cycle arrest in NB cells. In addition, microarray analysis showed that MI-773 led to significant downregulation of genes involved in the G2/M phase checkpoint and upregulation of hallmark gene associated with the p53 pathway. Meanwhile, knockdown of insulinoma-associated 1 decreased proliferation and increased apoptosis of NB cells. In conclusion, the present study demonstrated that MI-773 exhibited high selectivity and blockade affinity for the interaction between MDM2 and TP53 and may serve as a novel strategy for the treatment of NB.
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Affiliation(s)
- Yan-Ling Chen
- School of Basic Medicine and Biological Sciences, Soochow University, Suzhou, Jiangsu 215003, P.R. China.,Institute of Pediatric Research, Children's Hospital of Soochow University, Suzhou, Jiangsu 215003, P.R. China
| | - Zi-Mu Zhang
- Institute of Pediatric Research, Children's Hospital of Soochow University, Suzhou, Jiangsu 215003, P.R. China
| | - Xiao-Lu Li
- Institute of Pediatric Research, Children's Hospital of Soochow University, Suzhou, Jiangsu 215003, P.R. China
| | - Yan-Fang Tao
- Institute of Pediatric Research, Children's Hospital of Soochow University, Suzhou, Jiangsu 215003, P.R. China
| | - Shui-Yan Wu
- Intensive Care Unit, Children's Hospital of Soochow University, Suzhou, Jiangsu 215003, P.R. China
| | - Fang Fang
- Institute of Pediatric Research, Children's Hospital of Soochow University, Suzhou, Jiangsu 215003, P.R. China
| | - Yi Xie
- Institute of Pediatric Research, Children's Hospital of Soochow University, Suzhou, Jiangsu 215003, P.R. China
| | - Xin-Mei Liao
- Institute of Pediatric Research, Children's Hospital of Soochow University, Suzhou, Jiangsu 215003, P.R. China
| | - Gen Li
- Institute of Pediatric Research, Children's Hospital of Soochow University, Suzhou, Jiangsu 215003, P.R. China
| | - Di Wu
- Institute of Pediatric Research, Children's Hospital of Soochow University, Suzhou, Jiangsu 215003, P.R. China
| | - Hai-Rong Wang
- Institute of Pediatric Research, Children's Hospital of Soochow University, Suzhou, Jiangsu 215003, P.R. China
| | - Ran Zuo
- School of Basic Medicine and Biological Sciences, Soochow University, Suzhou, Jiangsu 215003, P.R. China.,Institute of Pediatric Research, Children's Hospital of Soochow University, Suzhou, Jiangsu 215003, P.R. China
| | - Hai-Bo Cao
- Institute of Pediatric Research, Children's Hospital of Soochow University, Suzhou, Jiangsu 215003, P.R. China
| | - Jing-Jing Pan
- Institute of Pediatric Research, Children's Hospital of Soochow University, Suzhou, Jiangsu 215003, P.R. China
| | - Juan-Juan Yu
- Institute of Pediatric Research, Children's Hospital of Soochow University, Suzhou, Jiangsu 215003, P.R. China
| | - Zheng Zhang
- Institute of Pediatric Research, Children's Hospital of Soochow University, Suzhou, Jiangsu 215003, P.R. China
| | - Xin-Ran Chu
- Institute of Pediatric Research, Children's Hospital of Soochow University, Suzhou, Jiangsu 215003, P.R. China
| | - Yong-Ping Zhang
- Institute of Pediatric Research, Children's Hospital of Soochow University, Suzhou, Jiangsu 215003, P.R. China
| | - Chen-Xi Feng
- Institute of Pediatric Research, Children's Hospital of Soochow University, Suzhou, Jiangsu 215003, P.R. China
| | - Jian-Wei Wang
- Institute of Pediatric Research, Children's Hospital of Soochow University, Suzhou, Jiangsu 215003, P.R. China
| | - Jun Lu
- Department of Hematology, Children's Hospital of Soochow University, Suzhou, Jiangsu 215003, P.R. China
| | - Shao-Yan Hu
- Institute of Pediatric Research, Children's Hospital of Soochow University, Suzhou, Jiangsu 215003, P.R. China.,Department of Hematology, Children's Hospital of Soochow University, Suzhou, Jiangsu 215003, P.R. China
| | - Zhi-Heng Li
- Institute of Pediatric Research, Children's Hospital of Soochow University, Suzhou, Jiangsu 215003, P.R. China
| | - Jian Pan
- Institute of Pediatric Research, Children's Hospital of Soochow University, Suzhou, Jiangsu 215003, P.R. China
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Xu S, Zhang W, Che B, Zhang J, He J, Liu D, Chen P, Mu Y, Chen K, Tang K. Adult adrenal neuroblastoma: A case report. Mol Clin Oncol 2021; 15:225. [PMID: 34548924 DOI: 10.3892/mco.2021.2378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Accepted: 07/14/2021] [Indexed: 11/06/2022] Open
Abstract
Adrenal neuroblastoma (NB) is very rare in adults. According to the literature, <100 cases have been reported worldwide to date, with >90% of the patients aged <10 years. As the early symptoms of the disease are not obvious, distant metastasis has often already occurred when the patients develop clinical symptoms. This lack of obvious symptoms may lead to misdiagnosis and inadequate treatment. Imaging and laboratory examinations are crucial for the diagnosis of NB, but reaching a definitive diagnosis prior to surgery is challenging, as the final diagnosis ultimately depends on histopathological examination. The aim of the present study was to report the rare case of a 40-year-old woman with adrenal left NB who underwent tumor resection. No tumor recurrence was observed at the 3-month and 1-year postoperative follow-up, but a repeat computed tomography at the 3-year postoperative follow-up indicated metastases; the patient refused further treatment and eventually succumbed to the disease within 1 month. The aim of the present case was to emphasize the importance of individualized therapy and long-term, close follow-up of the patients. The clinical characteristics and treatment of this case of adrenal NB were also summarized and analyzed in order to raise clinical awareness of this rare disease.
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Affiliation(s)
- Shenghan Xu
- Department of Urology, Affiliated Hospital of Guizhou Medical University, Guiyang, Guizhou 550004, P.R. China
| | - Wenjun Zhang
- Department of Urology, Affiliated Hospital of Guizhou Medical University, Guiyang, Guizhou 550004, P.R. China
| | - Bangwei Che
- Department of Urology, Affiliated Hospital of Guizhou Medical University, Guiyang, Guizhou 550004, P.R. China
| | - Jinjuan Zhang
- Department of Urology, Affiliated Hospital of Guizhou Medical University, Guiyang, Guizhou 550004, P.R. China
| | - Jun He
- Department of Urology, Affiliated Hospital of Guizhou Medical University, Guiyang, Guizhou 550004, P.R. China
| | - Dongdong Liu
- Department of Urology, Affiliated Hospital of Guizhou Medical University, Guiyang, Guizhou 550004, P.R. China
| | - Pan Chen
- Department of Urology, Affiliated Hospital of Guizhou Medical University, Guiyang, Guizhou 550004, P.R. China
| | - Yi Mu
- Department of Urology, Affiliated Hospital of Guizhou Medical University, Guiyang, Guizhou 550004, P.R. China
| | - Kehang Chen
- Department of Urology, Affiliated Hospital of Guizhou Medical University, Guiyang, Guizhou 550004, P.R. China
| | - Kaifa Tang
- Department of Urology, Affiliated Hospital of Guizhou Medical University, Guiyang, Guizhou 550004, P.R. China.,Institute of Medical Science of Guizhou Medical University, Guiyang, Guizhou 550004, P.R. China
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Surgical Management of Giant L2 Adrenal Neuroblastoma in Adult Male. Case Rep Urol 2020; 2020:8890223. [PMID: 33354378 PMCID: PMC7737448 DOI: 10.1155/2020/8890223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2020] [Revised: 11/25/2020] [Accepted: 11/28/2020] [Indexed: 11/25/2022] Open
Abstract
Neuroblastoma is an embryonal malignancy that arises from neural crest cells. Adult adrenal neuroblastoma is a rare disease, and less than 100 cases were reported in the literature. Adult neuroblastoma commonly presents with abdominal (retroperitoneal) lump and pain. A 35-year-old male patient presented with a giant (20 cm × 17 cm × 12 cm) nonfunctional left adrenal mass. He underwent en-bloc surgical excision of the left adrenal gland along with the left kidney. Histopathological examination revealed adrenal neuroblastoma (stage 2B, L2). We present here the surgical management of the rare adult adrenal neuroblastoma.
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Garrovillo K, Garrett J, Bollin K, Nasraty F, Sikand H. Dinutuximab in adult-onset chemotherapy refractory high-risk neuroblastoma. J Oncol Pharm Pract 2020; 26:2058-2065. [PMID: 32356686 DOI: 10.1177/1078155220918920] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
INTRODUCTION Neuroblastoma is the most common extracranial solid tumor in pediatrics but is considerably uncommon in adults, with approximately 1 case per 10 million diagnosed per year and is associated with poor prognosis. There are no standard treatment protocols for adult-onset neuroblastomas and there are only a few published case reports on neuroblastoma in adults. CASE REPORT We report our treatment experience in a 41-year-old female diagnosed with high-risk, poorly differentiated neuroblastoma. MANAGEMENT AND OUTCOME Our patient received two cycles of dinutuximab adapted from the Children's Oncology Group ANBL1221 protocol. The patient experienced pain, neuropathy, pruritus, and infusion reactions which were managed with supportive care. Due to the lack of tumor regression, dinutuximab was omitted from future treatments. Currently, the patient is asymptomatic from her disease and remains off of all therapy and pain medication. DISCUSSION While dinutuximab has produced promising outcomes in pediatric patients, it is not without potentially severe adverse effects. Serious reactions of capillary leak syndrome, infusion reactions, pain, and neuropathy have been reported. Clinicians must be cognizant of the treatment-related toxicities associated with dinutuximab therapy, ranging from pain, neuropathy, pruritus, and infusion reactions as explored in this patient case.
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Affiliation(s)
| | - John Garrett
- Department of Pharmacy, Scripps Mercy Hospital, San Diego, CA, USA
| | - Kathryn Bollin
- Department of Hematology/Oncology, Scripps Mercy Hospital, San Diego, CA, USA.,Department of Hematology/Oncology, Scripps Health, La Jolla, CA, USA
| | - Farah Nasraty
- Department of Hematology/Oncology, Scripps Health, La Jolla, CA, USA
| | - Harminder Sikand
- Department of Pharmacy, Scripps Mercy Hospital, San Diego, CA, USA
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Yan P, Qi F, Bian L, Xu Y, Zhou J, Hu J, Ren L, Li M, Tang W. Comparison of Incidence and Outcomes of Neuroblastoma in Children, Adolescents, and Adults in the United States: A Surveillance, Epidemiology, and End Results (SEER) Program Population Study. Med Sci Monit 2020; 26:e927218. [PMID: 33249420 PMCID: PMC7711874 DOI: 10.12659/msm.927218] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Background This United States (U.S.) population study aimed to compare the incidence of neuroblastoma and outcomes in children, adolescents, and adults using the Surveillance, Epidemiology, and End Results (SEER) program database. Material/Methods Patients with neuroblastoma were identified in the SEER database from 1975 to 2013. According to the age at diagnosis, patients were divided into “Children” (≤14 years old) and “Adolescents/Adults” group (>14 years old). Then, comparisons in basic characteristics, incidence rates (IRs) and long-term survival outcomes between patients in 2 groups were made. Results A total of 4280 patients were identified, including 3998 children and 282 adolescent/adult patients. Adolescent/adult patients were more likely to have localized diseases than children and to be diagnosed with ganglioneuroblastoma (all P<0.05). The IR of neuroblastoma presented with upward and downward trends in children and adolescent/adult populations, respectively. Adolescents/adults had worse overall survival (OS) than children despite the earlier tumor stage. Lastly, multivariate Cox proportional hazards analyses showed that tumor stage, histology, sequence of primary malignancy, primary site, the administration of surgery, and treatment era were prognostic factors for children, and sequence of primary malignancy, primary site, undergoing surgery, and treatment era were tightly related to OS in adolescent/adult patients. Conclusions Analysis of the SEER program database between 1975 to 2013 showed that in the U.S., the incidence of neuroblastoma in children increased, but the incidence decreased in adolescents and adults. There was a trend for improved overall survival in all age groups despite the increased stage at presentation in children.
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Affiliation(s)
- Ping Yan
- Department of Neonatal Surgery, Children's Hospital of Nanjing Medical University, Nanjing, Jiangsu, China (mainland)
| | - Feng Qi
- Department of Urologic Surgery, Jiangsu Cancer Hospital and Jiangsu Institute of Cancer Research and Affiliated Cancer Hospital of Nanjing Medical University, Nanjing, Jiangsu, China (mainland)
| | - Lanzheng Bian
- Department of Nursing, Children's Hospital of Nanjing Medical University, Nanjing, Jiangsu, China (mainland)
| | - Yajuan Xu
- Department of Neonatal Surgery, Children's Hospital of Nanjing Medical University, Nanjing, Jiangsu, China (mainland)
| | - Jing Zhou
- Department of Nursing, Children's Hospital of Nanjing Medical University, Nanjing, Jiangsu, China (mainland)
| | - Jiajie Hu
- Department of Nursing, Children's Hospital of Nanjing Medical University, Nanjing, Jiangsu, China (mainland)
| | - Lei Ren
- Department of Nursing, Children's Hospital of Nanjing Medical University, Nanjing, Jiangsu, China (mainland)
| | - Mei Li
- Department of Nursing, Children's Hospital of Nanjing Medical University, Nanjing, Jiangsu, China (mainland)
| | - Weibin Tang
- Department of Neonatal Surgery, Children's Hospital of Nanjing Medical University, Nanjing, Jiangsu, China (mainland)
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Vieceli T, Tavares ALJ, de Moraes RP, Faulhaber GAM. Metastatic adult neuroblastoma with spontaneous tumor lysis syndrome. Autops Case Rep 2020; 10:e2020181. [PMID: 33344311 PMCID: PMC7703274 DOI: 10.4322/acr.2020.181] [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] [Indexed: 12/28/2022]
Abstract
Neuroblastoma (NB) is a solid tumor of the sympathetic nervous system, most commonly found in childhood, standing for 7% of all pediatric malignancies. The incidence in adults is markedly smaller: 1 case per 10 million adults per year. We report the case of a previously healthy 27-year-old woman who started with lumbar pain, asthenia, and abdominal distension over the last month. A chest and abdomen tomography scan showed a huge mass in the upper left hemithorax and marked hepatomegaly. The diagnosis was confirmed by hepatic and lung biopsies. On day 4, after admission, the patient started chemotherapy. On the following days, she had severe vaginal bleeding, epistaxis, worsening of the hepatic function markers, refractory shock, and multiple organ dysfunction. She died on the twelfth day of admission. We also present a review of adult cases of NB reported in the past 5 years.
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Affiliation(s)
- Tarsila Vieceli
- Hospital de Clinicas de Porto Alegre, Internal Medicine Department. Porto Alegre, RS, Brazil
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14
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Immediate Response to Chemotherapy in an Adult Neuroblastoma Patient Presenting with Cord Compression. Case Rep Neurol Med 2020; 2020:6401497. [PMID: 32148983 PMCID: PMC7049824 DOI: 10.1155/2020/6401497] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2019] [Revised: 12/29/2019] [Accepted: 02/03/2020] [Indexed: 12/04/2022] Open
Abstract
We report a case of a 31-year-old female patient with high-risk neuroblastoma (NBL) who presented with a history of static back pain and bilateral lower limb weakness for almost a month. Her primary tumor was located in the right paraspinal region, causing spinal cord compression (SCC). Chemotherapy was administered with an immediate clinical improvement noted after 24 hours of starting treatment. We herein report the efficacy of chemotherapy in an adult neuroblastoma (aNBL) patient presenting with spinal cord compression.
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15
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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
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16
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Zhang H, Feng Z. Adrenal neuroblastoma in an elderly adult: a case report and review of the literature. J Med Case Rep 2019; 13:284. [PMID: 31500669 PMCID: PMC6734506 DOI: 10.1186/s13256-019-2204-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2018] [Accepted: 07/23/2019] [Indexed: 12/01/2022] Open
Abstract
Background Neuroblastoma is an embryonal malignancy of the autonomic nervous system and is the most common extracranial tumor of early childhood. However, neuroblastoma in adults is rare with an overall incidence of 1 in 10 million adults/year. Adults with neuroblastoma have a significantly worse prognosis than children with neuroblastoma. Case presentation In this case report we describe a 75-year-old Han Chinese woman with bilateral lower extremities weakness, numbness, and fatigue for 1 week. She initially presented as primary hyperaldosteronism with hypertension, persistent hypokalemia, and an elevated aldosterone/plasma renin activity ratio. An abdominal computed tomography scan with intravenously administered contrast showed a solid mass arising from her left adrenal gland. She underwent retroperitoneal laparoscopic surgery that allowed the resection of the mass. Microscopic and immunohistochemical staining, which were positive for synaptophysin, CD56, and vimentin, confirmed the diagnosis of adrenal neuroblastoma. Surgical resection of the tumor was done and no chemotherapy or radiation therapy was done postoperatively. She died from lung and brain metastases 22 months after surgical resection. Conclusion Adrenal neuroblastoma in elderly adults is a very rare disease with sparse data available in the literature. Early stage disease could be managed by surgical resection alone. However, the prognosis is significantly worse than that observed in pediatric patients. Further research focusing on tumor biology and therapy for this rare malignancy in adults may help to improve disease outcome.
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Affiliation(s)
- Haibin Zhang
- Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, China
| | - Ziwei Feng
- Division of Urology, Guangdong General Hospital, Guangdong Academy of Medical Sciences, No.106 Zhongshan Er Road, Guangzhou, 510080, Guangdong, China.
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17
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Abstract
RATIONALE Neuroblastoma is one of the most common malignant tumors in childhood, which mainly occurs in adrenal glands and peripheral sympathetic nerve system. Neuroblastoma occurring in adulthood is rare, and adults with neuroblastoma arising from thorax are exceedingly rare. A case of neuroblastoma that originated from thorax was reported, and was treated by resection operation. PATIENT CONCERNS A 46-year-old woman was admitted to our hospital with left side chest pain for 5 days. Laboratory examinations were all normal. Chest computerized tomogram (CT) showed a lesion with clear boundary that was located at the left dorsal pleura. The nature of the mass was heterogeneous, showing slight heterogeneous enhancement after contrast and there was no obvious necrosis. DIAGNOSES Based on the morphologic and immunohistochemical features, the tumor diagnosis was favorable for neuroblastoma. INTERVENTIONS A resection operation was carried out. OUTCOMES Three years postoperative, no sign of recurrence or metastasis has been observed. LESSONS Primary neuroblastoma in adulthood is rare and has poor prognosis. Resection can be an important treatment option, and combining with other methods like chemotherapy, stem cell transplantation, the survival rate may be improved.
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Affiliation(s)
| | | | - Wen-Shan Li
- Department of Thoracic Surgery, Zhejiang University School of Medicine Second Affiliated Hospital, Hangzhou, China
| | - Run-Lin Yang
- School of Medicine, University of Melbourne, Melbourne, Australia
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18
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Naeem M, Maluf H, Baker JC, Jennings JW. Primary osseous sacral neuroblastoma in an adult. Skeletal Radiol 2019; 48:985-988. [PMID: 30269206 DOI: 10.1007/s00256-018-3081-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2018] [Revised: 09/06/2018] [Accepted: 09/18/2018] [Indexed: 02/02/2023]
Abstract
Neoplasms of the sacrum are rare. Given the non-specific imaging findings in sacral lesions, the imaging-based differential diagnosis is always difficult. This case is about an adult with primary sacral neuroblastoma and we have discussed imaging and histopathological findings of this rare tumor.
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Affiliation(s)
- Muhammad Naeem
- Musculoskeletal Imaging and Interventions Section, Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO, USA
| | - Horacio Maluf
- Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, MO, USA
| | - Jonathan C Baker
- Musculoskeletal Imaging and Interventions Section, Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO, USA
| | - Jack W Jennings
- Musculoskeletal Imaging and Interventions Section, Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO, USA. .,Division of Musculoskeletal Imaging and Interventions, Mallinckrodt Institute of Radiology, Washington University School of Medicine, Campus box 8131, 510 South Kingshighway Boulevard, Saint Louis, MO, 63110, USA.
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19
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Ramsingh J, Casey H, Watson C. Adult neuroblastoma: a rare diagnosis of an adrenal mass. BMJ Case Rep 2019; 12:12/4/e228730. [PMID: 30975781 DOI: 10.1136/bcr-2018-228730] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
A 22-year-old woman presented to her local district hospital with left-sided abdominal pain. She denied any urinary or gastrointestinal symptoms. She had a CT scan of her abdomen which showed a probable 8×5×8 cm left-sided adrenal mass. Functional tests for hormone excess were negative. She was referred to a tertiary referral centre and given the size of the adrenal mass; she consented for laparoscopic left adrenalectomy. During the operation, the mass was grossly adherent to the celiac axis, left renal pedicle and DJ flexure. A small nodule posterior to the renal vein was also identified. The operation was completed laparoscopically and she made an uneventful recovery. The specimen was reported as a poorly differentiated neuroblastoma. She had a postoperative MIBG scan which was negative for residual or metastatic disease. She was commenced on platinum-based chemotherapy with a plan for further radiological follow-up.
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Affiliation(s)
- Jason Ramsingh
- Department of General Surgery, Queen Elizabeth University Hospital Campus, Glasgow, UK
| | - Helen Casey
- Department of General Surgery, Queen Elizabeth University Hospital Campus, Glasgow, UK
| | - Carol Watson
- Department of General Surgery, Queen Elizabeth University Hospital Campus, Glasgow, UK
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20
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Abstract
CONTEXT Neuroblastoma is the most common extracranial malignant solid tumor that occurs during childhood. It arises from primitive cells and is seen in the adrenal medulla and sympathetic ganglia of the sympathetic nervous system. CASE REPORT We present a rare case of a 40-year-old man who was diagnosed with the onset of neuroblastoma arising in the mediastinum. He was treated by means of surgical resection in the superior mediastinum after neoadjuvant chemotherapy. The patient's surgical outcome was satisfactory. CONCLUSION There are still no standard treatment guidelines for adult neuroblastoma patients. Although they have a poor prognosis, the main treatment option should be complete surgery at an early stage. This situation may become clarified through biological and genetic studies in the future.
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Affiliation(s)
- Fazli Yanik
- MD. Assistant Professor, Department of Thoracic Surgery, Trakya Üniversitesi Tip Fakültesi, Edirne, Turkey.
| | | | - Yener Yoruk
- MD. Professor, Department of Thoracic Surgery, Trakya Üniversitesi Tip Fakültesi, Edirne, Turkey.
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21
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Suzuki M, Kushner BH, Kramer K, Basu EM, Roberts SS, Hammond WJ, LaQuaglia MP, Wolden SL, Cheung NKV, Modak S. Treatment and outcome of adult-onset neuroblastoma. Int J Cancer 2018; 143:1249-1258. [PMID: 29574715 DOI: 10.1002/ijc.31399] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2017] [Revised: 02/08/2018] [Accepted: 02/27/2018] [Indexed: 12/15/2022]
Abstract
Adult-onset neuroblastoma is rare and little is known about its biology and clinical course. There is no established therapy for adult-onset neuroblastoma. Anti-GD2 immunotherapy is now standard therapy in children with high-risk neuroblastoma; however, its use has not been reported in adults. Forty-four adults (18-71 years old) diagnosed with neuroblastoma between 1979 and 2015 were treated at Memorial Sloan Kettering Cancer Center. Five, 1, 5 and 33 patients had INSS stage 1, 2, 3 and 4 diseases, respectively. Genetic abnormalities included somatic ATRX (58%) and ALK mutations (42%) but not MYCN-amplification. In the 11 patients with locoregional disease, 10-year progression-free (PFS) and overall survival (OS) was 35.4 ± 16.1% and 61.4 ± 15.3%, respectively. Among 33 adults with stage 4 neuroblastoma, 7 (21%) achieved complete response (CR) after induction chemotherapy and/or surgery. Seven patients with primary refractory neuroblastoma (all with osteomedullary but no soft tissue disease) received anti-GD2 antibodies, mouse or humanized 3F8. Antibody-related adverse events were similar to those in children, response rate being 71.4%. In patients with stage 4 disease at diagnosis, 5-year PFS was 9.7± 5.3% and most patients who were alive with disease at 5 years died of neuroblastoma over the next 5 years, 10-year OS being only 19.0 ± 8.2%. Patients who achieved CR after induction had superior PFS and OS (p = 0.006, p = 0.031, respectively). Adult-onset neuroblastoma appeared to have different biology from pediatric or adolescent NB, and poorer outcome. Complete disease control appeared to improve long-term survival. Anti-GD2 immunotherapy was well tolerated and might be beneficial.
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Affiliation(s)
- Maya Suzuki
- Department of Pediatrics, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Brian H Kushner
- Department of Pediatrics, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Kim Kramer
- Department of Pediatrics, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Ellen M Basu
- Department of Pediatrics, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Stephen S Roberts
- Department of Pediatrics, Memorial Sloan Kettering Cancer Center, New York, NY
| | - William J Hammond
- Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY
| | | | - Suzanne L Wolden
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Nai-Kong V Cheung
- Department of Pediatrics, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Shakeel Modak
- Department of Pediatrics, Memorial Sloan Kettering Cancer Center, New York, NY
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22
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He Y, Yao M, Zhang X, Sun P, Gao H. A very rare adult case of cervical neuroblastoma. INTERNATIONAL JOURNAL OF CLINICAL AND EXPERIMENTAL PATHOLOGY 2017; 10:8746-8750. [PMID: 31966735 PMCID: PMC6965434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 03/19/2017] [Accepted: 04/21/2017] [Indexed: 06/10/2023]
Abstract
Neuroblastoma is the most common malignancy in children, but it rarely occurs in adults, especially in the female genital system. Here, we report a case of a 28-year-old woman who was diagnosed with uterine cervical neuroblastoma. A microscopic examination revealed that tumor cells in the solid component were interspersed within an abundant fibrillary background and separated by thin fibrous septa that were composed of mats of neuropil. Immunohistochemistry showed that the cells were positive for vimentin and neuroendocrine markers, such as CD56, NSE, and synaptophysin. Clinical management of neuroblastoma must be tailored to the pathological diagnosis. Cases of neuroblastoma that originate in the cervix of an adult patient are rare, and few treatment strategies and chemotherapeutic protocols are therefore available. The case reported here provides information regarding our experience with a pathological diagnosis of such a cancer and the treatment protocol used to manage it.
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Affiliation(s)
- Yangyang He
- Department of Pathology, The Second Hospital of Jilin UniversityChangchun 130041, China
| | - Min Yao
- Department of Pathology, The Second Hospital of Jilin UniversityChangchun 130041, China
| | - Xin Zhang
- Department of Anesthesiology, The Second Hospital of Jilin UniversityChangchun 130041, China
| | - Pingli Sun
- Department of Pathology, The Second Hospital of Jilin UniversityChangchun 130041, China
| | - Hongwen Gao
- Department of Pathology, The Second Hospital of Jilin UniversityChangchun 130041, China
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23
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Godkhindi VM, Basade MM, Khan K, Thorat K. Adult Neuroblastoma-Case Report and Literature Review. J Clin Diagn Res 2016; 10:ED01-ED02. [PMID: 28208865 DOI: 10.7860/jcdr/2016/20237.9080] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2016] [Accepted: 09/20/2016] [Indexed: 12/29/2022]
Abstract
Neuroblastoma is the most common solid malignant neoplasm in the paediatric age group; accounting for 7% of all childhood malignancies, but neuroblastoma in adult, is a rare occurrence, finding mention in aeons of medical literature with an overall incidence of 1 in 10 million adults/year. We report the case of a 24-year-old male patient presenting with the complaints of progressive abdominal distention of 2 months duration. Multiple Detector Computed Tomography (MD-CT) of abdomen revealed a huge enhancing mass in the retroperitoneum abutting the left kidney, and a subsequent CT-guided biopsy and immunohistochemistry confirmed the diagnosis of ganglioneuroblastoma. The patient was administered 3-cycles of neo-adjuvant chemotherapy with ifosphamide, carboplatin and etoposide (ICE-chemotherapy) and subsequently 3 more cycles of chemotherapy post surgery, followed by radiation. The rarity of this neoplasm in adults accounts for the lack of standardized staging and treatment protocols and the dismal prognosis even with aggressive multimodal treatment. We report this case because of its extreme rarity, and its tendency for capricious behavior.
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Affiliation(s)
- Vishwapriya Mahadev Godkhindi
- Consultant Pathologist and Haematopathologist, Department of Pathology and Haematopathology, Vedant Multispeciality Hospital , Thane, Maharashtra, India
| | - Maheboob M Basade
- Consultant Oncologist and Head, Department of Oncology, Saifee Hospital , Mumbai, Maharashtra, India
| | - Kamran Khan
- Consultant Oncosurgeon, Department of Oncosurgery, Saifee Hospital , Mumbai, Maharashtra, India
| | - Kiran Thorat
- Consultant Oncopathologist, Department of Pathology, Saifee Hospital , Mumbai, Maharashtra, India
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24
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Adrenal Neuroblastoma in an Adult: Effect of Radiotherapy on Local Progression after Surgical Removal. Case Rep Urol 2016; 2016:2657632. [PMID: 27547479 PMCID: PMC4978852 DOI: 10.1155/2016/2657632] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2016] [Accepted: 06/16/2016] [Indexed: 11/17/2022] Open
Abstract
Here, we report the case of a 62-year-old man with neuroblastoma, which is extremely rare in adults. His tumor was resected, but it recurred four months later. Radiotherapy reduced tumor size, and the patient remained in good health three years after surgical tumor removal. The residual tumor and the treatments administered to this patient were evaluated. We have also reviewed the literature.
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25
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Right adrenal gland neuroblastoma infiltrating the liver and mimicking mesenchymal hamartoma: A case report. Int J Surg Case Rep 2015; 12:95-8. [PMID: 26036461 PMCID: PMC4486106 DOI: 10.1016/j.ijscr.2015.05.024] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2015] [Revised: 05/08/2015] [Accepted: 05/19/2015] [Indexed: 11/29/2022] Open
Abstract
The right adrenal gland neuroblastoma and infiltrated the adjacent liver substance mimicking mesenchymal hamartoma of the liver. The Presentation of fever of unknown origin in a case of right adrenal gland neuroblastoma is rare. Neuroblastoma should be considered in differential diagnosis of abdominal mass in all infants and children.
Introduction Neuroblastoma is the most common extracranial solid pediatric malignancy. The most common site is abdomen with predominance of suprarenal medulla. Infiltration of the tumour to the liver is rare. No cases were reported in the literature about the misdiagnosis of neuroblastoma as mesenchymal hamartoma in the liver. Presentation of case We represent a rare case of neuroblastoma misdiagnosed as mesenchymal hamartoma in liver in a six-month-old female infant presented with fever and abdominal mass. Abdominal computed tomography (CT) revealed large cystic lesion occupying most of the right liver enchroaching upon right suprarenal region and displacing the right kidney inferior suggestive for mesenchymal hamartoma. Right adrenalectomy with en-bloc resection of the adjacent liver segments was done. Postoperative pathology revealed neuroblastoma with positive specific immunohistochemistry (IHC). Discussion Although neuroblastoma is the second most common pediatric abdominal malignancy with specific diagnostic modalities, a misdiagnosis of a case with neuroblastoma as mesenchymal hamartoma is rare. Histopathological diagnosis of neuroblastoma with positive IHC is essential as shown in our case. Conclusion We represent a rare case of neuroblastoma which arose from the right adrenal gland and infiltrated the adjacent liver substance mimicking mesenchymal hamartoma of the liver. Neuroblastoma is rarely presented with pyrexia of unknown origin. Neuroblastoma should be considered in differential diagnosis of abdominal mass in all infants and children.
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