Pelvic neuroblastoma: Low mortality and high morbidity*
Section snippets
Materials and methods
We reviewed the records of 284 patients with neuroblastoma treated in Great Ormond Street Hospital for Children between January 1983 and December 1998 and identified 17 (6%) with pelvic tumors. Fourteen patients were diagnosed and treated in our hospital, and the other 3 were referred after initial treatment in another hospital.
Each patient's disease was staged retrospectively using the criteria of the International Neuroblastoma Staging System.9 In this system a grossly resectable pelvic tumor
Patient characteristics
The median age of patients at diagnosis was 10 months (range, 6 weeks to 10 years). Fourteen children (82%) were less than 2 years old, of whom, 10 were less than 1 year old. The male to female ratio was 2.4:1, which is a comparable figure to that reported previously.2, 3, 4 The diagnosis of neuroblastoma was established on the basis of raised urinary catecholamine metabolites (10 patients) and/or histology of a pretreatment percutaneous biopsy (8 patients). There were 6 patients with stage 1
Discussion
The incidence of pelvic neuroblastoma in our series was 6%, which is comparable to other reports (2% to 5.6%).1, 2, 3, 4, 13 Our study confirms the excellent survival rate of children with pelvic neuroblastomas but highlights the high incidence of permanent neurological complications, often after tumor resection.
The clinical presentation of pelvic neuroblastomas is different from that of tumors arising in other parts of the abdomen.14 More than half of our patients presented with a palpable
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Cited by (36)
Management of Neuroblastoma in Pediatric Patients
2021, Surgical Oncology Clinics of North AmericaCitation Excerpt :Excision of retroperitoneal neuroblastomas can result in nephrectomy or renal infarction.42 After the removal of pelvic tumors, there is increased frequency of complications, such as foot drop.43 Despite the extent of these massive resections, operative mortality is rare.
Neuroblastoma: Current advancements and future therapeutics
2021, Advanced Drug Delivery Systems in the Management of CancerThe Clinical Management and Outcomes of Pelvic Neuroblastic Tumors
2020, Journal of Surgical ResearchCitation Excerpt :Pelvic neuroblastomas are rare, representing only 3%-5% of all neuroblastic tumors identified annually. Historically, pelvic tumors, such as other extra-abdominal neuroblastic tumors, were believed to carry a favorable prognosis, with improved survival rates relative to intraabdominal tumors.3,4 In a 2014 report from the International Neuroblastoma Risk Group, a survival advantage was observed for patients with primary pelvic disease, despite concurrent data demonstrating that, across all primary sites, pelvic tumors presented at stage III with greater frequency.5
Advances in the surgical treatment of neuroblastoma
2019, Neuroblastoma: Molecular Mechanisms and Therapeutic InterventionsMononeuropathies
2015, Neuromuscular Disorders of Infancy, Childhood, and Adolescence: A Clinician's ApproachNeuroblastoma causing acute urinary retention: A rare presentation
2010, Journal of Emergency MedicineCitation Excerpt :The presentation of pelvic neuroblastoma is different from that of tumors arising in other parts of the abdomen. More than half present with a palpable mass, and approximately one-third also present with urinary retention or constipation (14). In addition to a complete history, the evaluation used to identify an organic cause of acute urinary retention in children should begin with a detailed abdominal, genitourinary, and neurological examination, which is essential to an accurate diagnosis.
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Address reprint requests to Agostino Pierro, Department of Paediatric Surgery, Institute of Child Health, 30 Guilford St, London, WC1N 1EH England.