Abstract
Neuroblastoma is the most common embryonal tumor of childhood and has a variable presentation. Stage 4S neuroblastoma, described as a localized primary tumor in an infant with metastasis to skin, liver, or bone marrow, is an exception to the poor prognosis seen in widespread metastasis of neuroblastoma. Survival in infants with this stage of the disease is over 90%. Stage 4S with massive liver involvement, however, confers a poor prognosis. We need more research on the optimum treatment modality for patients with Stage 4S disease and massive hepatomegaly to improve patient outcomes.
Highlights
Neuroblastoma is an embryonic tumor of the peripheral sympathetic nervous system [1]
We report a case of a three-month-old infant who presented with neuroblastoma with massive hepatomegaly
Ultrasound-guided biopsy of the liver revealed a tumor with small, round blue cells (Figure 3), and immunohistochemistry was positive for synaptophysin, confirming the diagnosis of infantile neuroblastoma (Figure 4)
Summary
Neuroblastoma is an embryonic tumor of the peripheral sympathetic nervous system [1] It is one of the most common extra-cranial solid tumors in children, comprising 8-10% of all childhood tumors [2]. We report a case of a three-month-old infant who presented with neuroblastoma with massive hepatomegaly. There was no observed jaundice or any significant skin marks On inspection, his abdomen was grossly distended with massive hepatomegaly. A large rounded soft tissue density nodule was seen in the right suprarenal location showing gradual enhancement and raising suspicion for neuroblastoma (Figure 2). Ultrasound-guided biopsy of the liver revealed a tumor with small, round blue cells (Figure 3), and immunohistochemistry was positive for synaptophysin, confirming the diagnosis of infantile neuroblastoma (Figure 4). In a local outside hospital, the patient was diagnosed with febrile neutropenia and passed away secondary to sepsis
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