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
Pediatricsjournal_title
Pediatricsauthors
Ho PT,Estroff JA,Kozakewich H,Shamberger RC,Lillehei CW,Grier HE,Diller Lsubject
Has Abstractpub_date
1993-09-01 00:00:00pages
358-64issue
3eissn
0031-4005issn
1098-4275journal_volume
92pub_type
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