Abstract：
PURPOSE:Although occasionally difficult, distinguishing abdominal neuroblastoma (NBL) from Wilms tumor (WT) at presentation is important, as surgical management differs significantly. We reviewed our 20-year experience (1987-2006) treating patients with NBL, focusing on those with an initial diagnosis of WT, to determine presenting features that would have suggested the correct preoperative diagnosis. METHODS:Retrospective case cohort study reviewing charts and imaging of patients with NBL initially diagnosed clinically with WT. Preoperative symptoms, laboratory studies, and imaging were evaluated. Similar variables were assessed in the 20 patients with WT most recently treated at our institution. RESULTS:Nine patients with NBL were identified as those who had an exploratory laparotomy with a preoperative diagnosis of WT; 8 underwent nephrectomy at exploration. Children with NBL had symptoms such as fever and weight loss at presentation (67%) more often than patients with WT (20%). Preoperative computed tomography demonstrated intratumoral calcifications, vascular encasement, or both in 78% of patients with NBL but were never seen in WT patients. Of interest, preoperative urinary catecholamines were elevated in 5 patients ultimately diagnosed with NBL. CONCLUSION:Although NBL can be mistaken for WT at presentation, the presence of constitutional symptoms, or intratumoral calcification or vascular encasement on preoperative imaging should heighten suspicion for NBL. In addition, laboratory evaluation, including urinary catecholamines, should be completed before surgery when the etiology of an abdominal tumor is uncertain.
journal_name
J Pediatr Surgjournal_title
Journal of pediatric surgeryauthors
Dickson PV,Sims TL,Streck CJ,McCarville MB,Santana VM,McGregor LM,Furman WL,Davidoff AMdoi
10.1016/j.jpedsurg.2008.02.047subject
Has Abstractpub_date
2008-06-01 00:00:00pages
1159-63issue
6eissn
0022-3468issn
1531-5037pii
S0022-3468(08)00184-Xjournal_volume
43pub_type
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journal_title：Journal of pediatric surgery
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journal_title：Journal of pediatric surgery
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pub_type： 杂志文章,多中心研究
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journal_title：Journal of pediatric surgery
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journal_title：Journal of pediatric surgery
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更新日期：2015-06-01 00:00:00
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journal_title：Journal of pediatric surgery
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journal_title：Journal of pediatric surgery
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journal_title：Journal of pediatric surgery
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pub_type： 临床试验,杂志文章
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abstract：BACKGROUND:Within the adult population, there exist numerous validated risk stratification tools aimed at predicting postoperative outcomes using preoperative and intraoperative parameters. However, similar tools for the pediatric population are scarce. We previously developed and reported on a scoring system to predic...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
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