Massive Intra-Tumor Hemorrhage during Induction Chemotherapy in Neuroblastoma: A Case Series Report

doi:10.13188/2377-9292.1000015

Abstract

Highlights

NB is the most common extra-cranial solid tumor in children
On rare occasions young infants with NB present with acute massive hemorrhage that result from spontaneous tumor rupture or follows minimal trauma [2,3]
With IRB approval, we retrospectively reviewed charts of all NB patients at King Hussein Cancer Center (KHCC) between 2006 and 2015, and found 5 children who developed acute hemorrhagic shock prior to local surgical control

Summary

Introduction

Multiple risk factors have been identified and subsequently used in treatment protocols with the aim of increasing survival and decreasing treatment related morbidity. At presentation and before initiation of chemotherapy CT scan in some children shows intra-tumor single or multiple foci of hemorrhage [1]. On rare occasions young infants with NB present with acute massive hemorrhage that result from spontaneous tumor rupture or follows minimal trauma [2,3]. Acute massive hemorrhage without tumor rupture is an exceptional event. Over the preceding 10 years we encountered few cases of NB who presented with massive hemorrhage shortly after initiation of their chemotherapy protocol and their tumor on CT scan remained intact. The aim of our report is to bring into attention this peculiar, potentially lethal incident and to share our experience in its diagnosis and treatment

Objectives

Discussion

Conclusion