Prenatal detection of neuroblastoma: a ten-year experience from the Dana-Farber Cancer Institute and Children's Hospital.

Abstract:

OBJECTIVES:To assess the relative frequency of, the clinical and pathological correlates in, and the prognosis of the subset of infants with neuroblastoma who were identified initially by prenatal ultrasonography. DESIGN:Retrospective review of all patients with neuroblastoma evaluated between 1982 and 1992. SETTING:Large, urban, tertiary care children's hospital in Boston, Massachusetts. PATIENTS:Eleven infants with neuroblastoma initially detected with prenatal sonograms were identified. RESULTS:Nine patients had adrenal tumors; two had thoracic paraspinal tumors. Typical diagnostic evidence for neuroblastoma including a palpable abdominal mass and elevations in urinary catecholamines were not commonly seen postnatally. These patients had multiple favorable prognostic indicators including low stage of disease (10/11), favorable biological markers including cellular DNA content (5/5) and N-myc oncogene copy number (5/5), and histopathology suggestive for neuroblastoma in situ (7/11). All patients were treated by surgical resection. One patient exhibited progression of disease postoperatively, but demonstrated a complete clinical response to multiagent chemotherapy. Overall survival in our population was excellent with no deaths seen at a mean follow-up of 37 months (range 3 to 120 months). CONCLUSIONS:Patients with neuroblastoma identified by prenatal ultrasonography generally, although not exclusively, follow a clinically favorable course in which surgical resection is curative. Chemotherapy is not indicated unless substantial progression of disease occurs.

journal_name

Pediatrics

journal_title

Pediatrics

authors

Ho PT,Estroff JA,Kozakewich H,Shamberger RC,Lillehei CW,Grier HE,Diller L

subject

Has Abstract

pub_date

1993-09-01 00:00:00

pages

358-64

issue

3

eissn

0031-4005

issn

1098-4275

journal_volume

92

pub_type

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