Neuroblastoma with ovarian and pancreatic metastasis

Abstract

Neuroblastoma metastasis to the pancreas and ovaries is rare. We report a 12-year-old girl diagnosed with primary left adrenal neuroblastoma and metastases to the local lymph nodes, left orbit, left ovary, and multiple bones. After 4 courses of chemotherapy, the orbital and bone metastases disappeared; the ovarian tumor remained and the lymph node metastases were shown to be pancreatic metastases. Left adrenal tumor resection with spleen-preserving partial pancreas resection and left ovariectomy was performed. Pathological examination of surgical specimens showed viable tumor cells in the ovary but none in the pancreas. Additional chemotherapy, autologous bone marrow transplantation, I 131 -MIBG radiotherapy, and radiation therapy were performed after surgery. This case was a case where it was possible to resect a rare metastatic site, and it is thought that there are many points to discuss about the metastatic pathway, evaluation about reactivity of chemotherapy, and indication about excision of metastatic lesions.