Signs of death from neuroblastoma

Neuroblastoma is a common childhood cancer that can metastasize to the skin. Children with this type of disease may have symptoms such as fever, pale complexion, and may also have abdominal pain and bloating. Neuroblastoma can be divided into many types depending on where it grows, such as pelvic neuroblastoma, dumbbell neuroblastoma, retroperitoneal neuroblastoma, etc. Let’s talk about neuroblastoma in detail.

1. Retroperitoneal neuroblastoma? Children often come to the doctor with unexplained fever and pale complexion. The mass compresses the abdominal organs and can cause digestive tract symptoms such as abdominal pain, bloating, loss of appetite, and vomiting. Tumors originating from the adrenal glands are difficult to palpate because they are located higher and are covered by the costal cartilage. Masses arising from the sympathetic nerve chain and large enough to be palpated as a firm, nodular, immobile, nontender mass in the abdomen often extend beyond the midline. Children in the late stage may have ascites, distended abdominal wall veins, abdominal wall edema, etc.

2. Pelvic neuroblastoma? Although pelvic neuroblastoma is rare, it is located in the anterior sacral depression behind the rectum. Once it occurs, symptoms will appear at an early stage due to compression of adjacent organs. Compression of the rectum often causes constipation, with the stool becoming flatter and thinner and defecation becoming difficult; compression of the bladder causes difficulty in urination or urine retention; and advanced tumors cause edema above the pubic bone and in the lower limbs due to compression of the lymphatic vessels and veins. Digital rectal examination may feel a firm mass in the anterior portion, but the upper pole is usually not palpable.

3. Dumbbell neuroblastoma? Dumbbell neuroblastoma refers to the neuroblastoma in the paravertebral part of the body cavity that extends through the intervertebral space into the epidural of the spinal canal. Mediastinal neuroblastomas are more common than abdominal neuroblastomas, but abdominal spinal neuroblastomas are more symptomatic and severe. Clinically, there may be spinal stiffness, paresthesia, pain, and hyperreflexia in the finger snap test. Limb muscle tension decreases, even paralysis occurs, and defecation and urination are impaired.

The causes of neuroblastoma in children are: one is congenital factors. The specific pathogenesis is not yet very clear. It may be the malignant transformation of residual embryonic tissue; the other is gene mutation, which is mainly related to genetic and environmental factors. About 1% to 22% of neuroblastoma is caused by gene mutation, while the disease caused by environmental factors is generally sporadic and the children are slightly older.

Surgery, chemotherapy, and radiotherapy are still the three main methods of treating neuroblastoma. Different intensities of treatment plans are used according to its clinical prognostic factors. Generally, surgical resection is recommended first, followed by chemotherapy for localized tumors, while for those who are estimated to be unresectable by surgery, the strategy of chemotherapy first, then surgery, then chemotherapy or radiotherapy is adopted. Drugs that are sensitive to neuroblastoma include cyclophosphamide, vincristine, etoposide, carboplatin, cisplatin, and anti-tumor antibiotics such as doxorubicin and ifosfamide.