Neuroblastoma in a 55-year-old patient: a case report

Primary osseous sacral neuroblastoma in an adult

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.

A very rare adult case of cervical neuroblastoma

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.

Thymic Neuroblastoma within a Thymic Cyst in an Adult

Case Presentation

A 65-year-old female patient with no clinical manifestations was hospitalized for examination and treatment of an anterior mediastinal tumor found at the time of a regular health checkup. Enhanced computed tomography (CT) and magnetic resonance imaging revealed a cystic lesion containing a solid tumor. Positron emission tomography-CT demonstrated increased uptake in the solid lesion. Tumor resection with total thymectomy was performed. A pathological diagnosis of thymic neuroblastoma within a thymic cyst was made. Micorscopic examination revealed that tumor cells of the solid component were lined with thymic epithelial cells of the inner cyst wall. Furthermore, some tumor cells of the solid component had melanin granules. These findings suggest that this tumor arose from progenitors of the thymic epithelial cells with the potential to differentiate along neural lines.

Conclusions

Neuroblastoma commonly occurs in children. However, the diagnosis of neuroblastoma in adults has been reported in several case reports. We report an adult case of histogenetically informative thymic neuroblastoma within a thymic cyst. There are no standard treatment strategies and chemotherapy protocols. Complete surgical resection might be important for a better outcome.