Bilateral neuroblastoma in situ associated with microcephaly.
Park W S,Chi J G
Journal of Korean medical science
We present an autopsy case of a two-day-old female infant with a very unusual combination of neuroblastoma in situ in both adrenals and microcephaly. This baby was born to a 28-year-old mother after 38 weeks of gestation, and died of respiratory difficulty 2 days later. At autopsy, the baby weighted 1,840gm, and the brain was extraordinarily small with a weight of 125gm. The gyral pattern was simplified and irregular. Microscopically massive migration defects, pachygyria, micropolygyria, leptomeningeal glioneuronal islands, small corticospinal tract and heterotopic Purkinje cells in the cerebellum were found. In addition, there were medullary nodules in both adrenals. They measured 0.7 x 0.4cm and 0.7 x 0.3cm, respectively. These nodules showed the typical histological features of undifferentiated neuroblastoma. The tumor nodules were confined to the medullary portion and did not extend to the cortex or contiguous structures meeting the criteria of neuroblastoma in situ. Based on these unusual and seemingly unrelated sets of findings, it is suggested that the histogenesis of neuroblastoma in situ could be a part of the generalized dysontogenic process.
10.3346/jkms.1993.8.2.99
Bilateral adrenal neuroblastoma.
Shaw A,Sabio H
The American journal of pediatric hematology/oncology
A 3-month-old female with bilateral adrenal neuroblastoma had a unilateral adrenalectomy followed by cyclophosphamide treatment for 2 years. At 7, she has no evidence of disease. The favorable course of this patient and that of another young child reported with bilateral neuroblastoma as well as wide-spread metastases suggests that bilateral adrenalectomy may not be necessary for a child under 1 year of age with bilateral disease.
Bilateral adrenal neuroblastoma.
Kramer S A,Bradford W D,Anderson E E
Cancer
Bilateral adrenal neuroblastoma is extremely rare, with isolated case reports considered to represent metastatic spread rather than simultaneous occurrence. This patient was found to have synchronous, separate, and equal size neoplasms that morphologically and ultrastructurally are neuroblastoma. We believe that these findings represent the unusual occurrence of simultaneous primary adrenal neuroblastoma reflecting multicentric origin of this neoplasm.
10.1002/1097-0142(19800415)45:8<2208::aid-cncr2820450833>3.0.co;2-a
[Bilateral adrenal neuroblastoma of multicentric origin].
Tamaro P,Fonda E,Valente M,Zanazzo G A
La Pediatria medica e chirurgica : Medical and surgical pediatrics
Bilateral neuroblastoma is extremely rare. In the literature few cases are reported which are mostly considered to represent metastases rather than multicentric tumoral occurrence. A case of bilateral adrenal neuroblastoma is reported; given its various aspects, and especially the prognosis features, this tumor is, in our opinion, of a multicentric origin.
An infant with bilateral adrenal neuroblastoma found by mass-screening: report of a case.
Kawaguchi F,Nakada K,Kitagawa H,Fujioka T,Kim Y,Enami T,Kuwabara M,Wakisaka M,Yamate N,Chihara H
Surgery today
A male infant with bilateral adrenal neuroblastoma found by mass-screening is herein reported. The patient presented with almost equal-sized tumors, each remaining confined to the respective adrenal gland without crossing the midline. No other tumorous lesion was evident. The two adrenal tumors had similar histologic features and appeared to have grown concurrently. Such simultaneous occurrence of primary adrenal neuroblastoma is unusual, and appears to reflect the multicentric origin of this tumor.
Metachronous bilateral adrenal neuroblastoma.
Suzuki H,Honzumi M,Funada M,Tomiyama H
Cancer
A boy with bilateral adrenal neuroblastoma was presented. The left adrenal neuroblastoma was found when he was at 5 years of age and was curatively excised. The right adrenal neuroblastoma was found when he was at 13 years of age and also was totally excised. The authors consider that the case presented is an extremely rare, metachronous primary bilateral adrenal neuroblastoma, reflecting the multicentric origin of neuroblastoma.
10.1002/1097-0142(19850915)56:6<1490::aid-cncr2820560645>3.0.co;2-k
Bilateral adrenal neuroblastoma.
Ishiguro Y,Iio K,Seo T,Nagaya M,Ito T
European journal of pediatric surgery : official journal of Austrian Association of Pediatric Surgery ... [et al] = Zeitschrift fur Kinderchirurgie
Two cases of bilateral adrenal neuroblastoma in infants are reported. The first patient presented with abdominal distension due to metastatic hepatomegaly and the second patient was found because of elevated urinary VMA by VMA mass-screening system. Both were under one year of age and were classified as stage IVs neuroblastoma. In each case unilateral adrenalectomy was performed and the contra-lateral adrenal tumor was observed. The remaining tumors slowly decreased in size and clinical progress was good. A review of published cases of bilateral adrenal neuroblastoma suggests that the characteristics of this disease are age less than 1 year, stage IVs, and good prognosis.
10.1055/s-2008-1066063
Hemoperitoneum and disseminated intravascular coagulation in two neonates with congenital bilateral neuroblastoma.
Vora D,Slovis T L,Boal D K
Pediatric radiology
We report two neonates with anemia, hemoperitoneum, and bilateral palpable abdominal masses. Both developed bleeding: a hemoperitoneum in one and visceral hemorrhages secondary to disseminated intravascular coagulation in the other. Each child was thought to have an unusual complication of adrenal hemorrhage, as the masses were of mixed echogenicity. However, histological evaluation revealed neuroblastoma. These cases point out the diagnostic dilemma of a mixed echogenicity suprarenal mass in the neonatal period and emphasize that local and disseminated bleeding can occur as a major manifestation of neuroblastoma.
10.1007/s002470050769
Bilateral adrenal cystic neuroblastoma with superior vena cava syndrome and massive intracystic haemorrhage.
Pinarli Faruk Guclu,Danaci Murat,Tander Burak,Dagdemir Ayhan,Diren Baris,Acar Sabri,Rizalar Riza
Pediatric radiology
Bilateral cystic adrenal tumours are a rare presentation of neuroblastoma. Intratumoural haemorrhage is a frequent finding in neuroblastoma, but is rarely symptomatic. We present an 11-month-old girl with predominantly cystic bilateral neuroblastomas and distant lymph-node metastasis. Massive intracystic haemorrhage and superior vena cava (SVC) syndrome were ominous prognostic factors, leading to death. Large tumours with intracystic haemorrhage might require a conservative approach.
10.1007/s00247-004-1209-5
A rare case of bilateral stage IV adrenal neuroblastoma with multiple skin metastases in a neonate: diagnosis, management, and outcome.
Yanai Toshihiro,Okazaki Tadaharu,Yamataka Atsuyuki,Fujita Hiroo,Saito Masahiro,Lane Geoffrey,Yamashiro Yuichiro,Miyano Takeshi
Journal of pediatric surgery
A neonate with stage IV bilateral adrenal neuroblastoma associated with metastases to the skin, liver, bone marrow, and right ocular conjunctiva is reported. At birth, skin metastases were present all over the body. He underwent a combination of chemotherapy, surgery, and peripheral blood stem cell transplantation (PBSCT). Histopathology was unfavorable with diploid tumor cell DNA content and low levels of TRK-A mRNA expression. Skin and conjunctival metastases disappeared after PBSCT, and there have been no signs of recurrence after 5 years of follow-up. Accurate staging of disease and histologic examination followed by intensive management are essential even in infants with neuroblastoma to ensure successful outcome.
10.1016/j.jpedsurg.2004.08.030
Bilateral hemorrhagic cystic adrenal neuroblastoma with liver and lymph nodal metastases in an infant.
Menon Prema,Bansal Deepak,Lyngdoh Soni,Gupta Kirti,Sodhi Kushaljit
Journal of Indian Association of Pediatric Surgeons
A 6-month-old boy presented with pallor, large left hypochondrial mass and hepatomegaly. Computerized tomography (CT) revealed cystic lesions in bilateral adrenals, liver and retroperitoneal lymph nodes and a lytic left femur lesion. There was hemorrhagic aspirate with round blue cells. Excised left sided mass with adjacent lymph nodes and biopsies of others confirmed well differentiated neuroblastoma. He received 4 cycles of chemotherapy with remaining lesions markedly reduced at 2 months CT scan. At 2 year follow up he is doing well.
10.4103/0971-9261.102340
Bilateral cystic adrenal neuroblastoma with cystic metastasis in the liver.
Chacko Jacob,Karl Sampath,Sen Sudipta,Eapen Anu,Mathai John
Journal of pediatric surgery
A 2 1/2-month-old infant presented with a massive hepatomegaly. Ultrasound and computerized tomography showed a large cystic lesion in the right adrenal, small cysts in the left adrenal, and multiple cystic liver metastases. The right adrenal cyst, on excision, turned out to be a cystic neuroblastoma with hemorrhage. On follow-up, the cysts in the left adrenal and the liver metastases are regressing.
10.1016/j.jpedsurg.2007.05.001
Bilateral adrenal cystic neuroblastoma with hepatic and splenic involvement in a newborn.
Köksal Yavuz,Varan Ali,Kale Gülsev,Tanyel Feridun Cahit,Büyükpamukçu Münevver
Journal of pediatric hematology/oncology
Bilateral cystic adrenal neuroblastoma is an unusual variant of neuroblastoma, and only two cases have been reported in the neonatal period until now. The authors describe a newborn with splenic and hepatic involvement of bilateral adrenal cystic neuroblastoma.
Stage 4S Bilateral Adrenal Neuroblastoma in a Newborn.
Gupta Rahul,Mala Tariq Ahmed,Mathur Praveen,Paul Rozy,Mala Shahid Amin
APSP journal of case reports
Stage 4S bilateral adrenal neuroblastoma presenting in the neonatal period is extremely rare. A 1-day-old male with 4Sbilateral adrenal neuroblastoma complicated by marked hepatomegaly managed by chemotherapy is being reported. The provisional diagnosis of neuroblastoma was made in the fetal life during the last trimester of pregnancy. Cardiomyopathy due to doxorubicin cytotoxicity developed over ensuing years, which is being treated.
Life-threatening bilateral adrenal cystic neuroblastoma in an infant.
Avanzini Stefano,Conte Massimo,Granata Claudio,Zamorani Enrica M,Sementa Angela R,Garaventa Alberto,Buffa Piero,Sorrentino Stefania
Journal of pediatric hematology/oncology
A case of neonatal bilateral adrenal mass causing severe respiratory distress and requiring an emergency debulking surgical procedure is reported. Histopathology revealed a cystic neuroblastoma stroma poor, poorly differentiated, without MYCN amplification and 1p deletion. During postoperative follow-up, a progression to stage 4s was observed, characterized by liver involvement. According to good prognostic indexes, no further treatment was administered. Both adrenal masses and hepatic nodules showed progressive decrease in size, till complete disappearance. The authors encourage a multidisciplinary approach to develop the best patient-related strategy for cystic neuroblastoma, thus reducing complications rate.
10.1097/MPH.0b013e3181b79641
Bilateral Cystic Adrenal Neuroblastoma with Cystic Liver metastasis.
Aslan Mine,Alis Deniz,Kalyoncu Ayse Ucar,Habibi Hatice Arioz,Ozdemir Gul Nihal,Koc Basak,Adaletli Ibrahim
APSP journal of case reports
Bilateral congenital cystic adrenal neuroblastoma (NB) with cystic liver metastasis is a very rare condition and only few cases have been reported in the literature. Herein we report a case of a congenital bilateral cystic adrenal NB with cystic liver metastasis and briefly discuss characteristic imaging features of cystic NB.
10.21699/ajcr.v8i1.517
Hemophagocytic Lymphohistiocytosis After Initiation of Chemotherapy for Bilateral Adrenal Neuroblastoma.
Nascimento Fábio A,Nery Juliane,Trennepohl Joanna,Pianovski Mara A D
Journal of pediatric hematology/oncology
Hemophagocytic lymphohistiocytosis (HLH) is a rare and aggressive syndrome characterized by overactivation of the immune system. Although secondary HLH has been frequently associated with malignancies, this entity is rarely triggered by solid tumors, such as neuroblastomas. Herein, we describe a 14-month-old girl with a late diagnosis of bilateral adrenal neuroblastoma who developed HLH 6 days after the initiation of chemotherapy. On the basis of the large tumoral mass and the time of onset of her symptoms suggestive of HLH, we hypothesize that tumor cell destruction induced by chemotherapy drugs was the trigger to the development of hematophagocytic lymphohistiocytosis syndrome.
10.1097/MPH.0000000000000469
Bilateral adrenal neuroblastoma is different.
Pederiva F,Andres A,Sastre A,Alves J,Martinez L,Tovar J A
European journal of pediatric surgery : official journal of Austrian Association of Pediatric Surgery ... [et al] = Zeitschrift fur Kinderchirurgie
BACKGROUND/AIMS:Bilateral adrenal neuroblastoma is rare and can be due to multifocal primary or contralateral metastasis. Staging is confusing in these patients and treatment guidelines are difficult to set. The present study examines the clinical, biological and therapeutic features of bilateral adrenal neuroblastoma. METHODS:We identified 4 cases primarily located in both adrenals out of 148 neuroblastomas treated between 1992 and 2006. We studied the clinicopathological findings and biological features, including MYCN amplification, and analyzed the treatment strategies and results. RESULTS:All patients were younger than 6 months of age and all had multiple liver metastases. Three had subcutaneous nodules and massive liver enlargement. All underwent chemotherapy prior to operation. Two babies had large bilateral tumors without preservable glands and underwent bilateral adrenalectomy. Both had MYCN gene amplification and died of widespread (brain and bone) metastases some weeks later. In the remaining two patients adrenalectomy was performed on the side of the larger tumor with tumor enucleation on the other side to preserve hormonal function followed by 2 courses of mild chemotherapy in one patient. These tumors were not amplified. Both of these children are doing well. CONCLUSIONS:Bilateral adrenal neuroblastomas fit neither into stage 4 s nor into stage 4. Their clinical behavior is exceptional with a number of multicystic forms, variable MYCN amplification, widespread metastases and a high mortality. Bilateral adrenalectomy is sometimes unavoidable, but unilateral removal with contralateral enucleation, partial resection or observation are valid alternatives. Mortality is higher than in regular stage 4 s cases. This particular group of neuroblastomas required individually tailored therapeutic strategies based on the size, extent and prognostic markers.
10.1055/s-2007-965811
Bilateral adrenal neuroblastoma: stage V disease.
Johnston Donna L,Sweeney Brian,Halton Jacqueline M
Journal of pediatric hematology/oncology
Neuroblastoma frequently arises from the adrenal gland and has rarely been reported to arise synchronously in both adrenal glands. The majority of reports of bilateral adrenal neuroblastoma are in children under the age of 1 year. We present a case of bilateral adrenal neuroblastoma in an 8-year-old child. This is the first report of bilateral disease in a child over the age of 1 year with stage IV neuroblastoma.
10.1097/MPH.0b013e318142b788