Neuroblastoma

Neuroblastoma is a rare childhood cancer that develops from immature nerve cells called neuroblasts. It most commonly begins in the adrenal glands above the kidneys but can also develop in the abdomen, chest, neck, or spine. It primarily affects infants and young children, and early diagnosis plays a vital role in improving treatment outcomes.

Common signs and symptoms of Neuroblastoma include:

• Lump or swelling in the abdomen, neck, or chest
• Abdominal pain or fullness
• Bone pain or limping
• Fever
• Unexplained weight loss
• Fatigue or weakness
• Loss of appetite
• Dark circles around the eyes
• High blood pressure
• Difficulty breathing (if located in the chest)

The exact cause of Neuroblastoma is unknown. It develops when immature nerve cells undergo genetic changes that cause uncontrolled growth. Most cases occur spontaneously, although a small percentage are linked to inherited genetic mutations.

Factors that may increase the risk of Neuroblastoma include:

• Age below five years
• Family history of Neuroblastoma (rare)
• Inherited genetic mutations (such as ALK gene mutations)
• Certain congenital genetic conditions

Most children with Neuroblastoma have no identifiable risk factors.

Doctors use several tests to accurately diagnose Neuroblastoma and determine its stage.

Common diagnostic investigations include:

• Physical examination
• Blood tests
• Urine catecholamine tests (VMA/HVA)
• Ultrasound
• CT Scan
• MRI Scan
• MIBG Scan
• PET-CT Scan (when required)
• Bone marrow aspiration and biopsy
• Tumor biopsy
• Genetic and molecular testing

Treatment depends on the child's age, risk category, and stage of the disease.

Treatment options may include:

• Surgery
• Chemotherapy
• Radiation therapy
• High-dose chemotherapy with stem cell transplant
• Immunotherapy
• Targeted therapy
• Precision medicine based on molecular profiling
• Long-term supportive and survivorship care

A multidisciplinary pediatric oncology team develops an individualized treatment plan for every child.

The outlook for Neuroblastoma varies depending on the child's age, disease stage, tumor biology, and risk group. Children with low-risk disease often have excellent survival rates, while high-risk Neuroblastoma requires more intensive treatment. Advances in precision medicine, immunotherapy, and multidisciplinary care continue to improve survival and quality of life.