Neuroblastoma

Short characteristic of a disease

The neuroblastoma is one of the most widespread malignant tumors which meet at children's age. This tumor takes the fourth place among new growths at children after leukoses, tumors of TsNS, malignant lymphoma and sarcomas. The tumor comes to light at quite early children's age, most often from 1 year to 3 years. The neuroblastoma at children can be localized in any part of a body, but localization behind a peritoneum and in the field of a postmediastinum has practical value.

Disease origins are up to the end not studied. Heredity is considered the only reliable factor.

Forms of neuroblastomas

Distinguish 4 forms of a neuroblastoma at children depending on type of cells and localization.

Melulloblastoma – is localized a tumor quite deeply in a cerebellum that makes impossible its removal by means of operation. It is characterized by bystry emergence of metastasises that leads to the bystry death of the child. The very first symptoms of development of a tumor are shown in an incoordination and balances.

The retinoblastoma is a malignant tumor which affects an eye retina at children. Development of a retinoblastoma leads to a blindness and metastasises in a brain.

The neurofibrosarcoma is a tumor of a sympathetic nervous system. It is localized in an abdominal cavity, gives metastasises in bones and lymph nodes.

The sympathoblastoma is a malignant tumor which is localized in a sympathetic nervous system and adrenal glands. It is formed at a fruit when forming a nervous system. The sympathoblastoma can be also localized in a chest cavity. Owing to increase in a tumor of adrenal glands the spinal cord can be surprised that it leads to paralysis of extremities.

Neuroblastoma stages

Distinguish 4 stages of development of a neuroblastoma in children:

The I stage - is characterized by localization of a neuroblastoma in the place of primary center;

The II stage – a tumor goes beyond primary center, but has no localization on other side of a backbone;

The III stage – a tumor extends to both sides of a backbone with damage of lymph nodes;

The IV stage – a neuroblastoma gives the remote metastasises in soft tissues, skeleton bones, lymph nodes, etc.

Neuroblastoma symptoms

The first signs of development of a neuroblastoma in children is pallor of integuments, decrease in apatite, vomiting, causeless whims, locks. Emergence of subfebrile temperature, increase of pulse, the increased perspiration, a hair loss is possible. In process of development and increase in a tumor the symptomatology accrues. It can be necessary for measurement of pulse rate пульсоксиметр.

At a retroperitoneal neuroblastoma increase in a circle of a stomach is observed, at a palpation the slow-moving and hilly tumor is probed. The costal arch can be turned out or protrusion in a waist from formation of a tumor is visible. It is quite often possible to notice a vascular grid in an upper part of a stomach and a thorax. The retroperitoneal neuroblastoma is characterized by very early changes in blood test, namely decrease in level of hemoglobin.

The neuroblastoma in the field of a mediastinum on an initial time proceeds asymptomatically. With progressing of a tumor its germination to the spinal canal is noted that leads to paralysis of upper and lower extremities, and also an incontience of urine and a chair.

Often parents notice symptoms of a disease which are caused not by a tumor, but metastasises. It is connected with the fact that the tumor early enough gives metastasises. The symptomatology depends on the place of localization of metastasises. At damage of bones of a skull it is possible to see tumoral hillocks, and also protrusion of eyes and hemorrhage on a pilar part of the head. At metastasises to the area of a liver its increase and tuberosity is observed. Damage of bones is characterized by pathological changes.

Diagnosis of a neuroblastoma

For diagnosis of a tumor perform inspection of the child with a stomach palpation thanks to which it is possible to reveal a tumor. Also appoint blood tests and urine, carry out ultrasonography and X-ray inspection, computer and magnetic and resonant therapy. The final diagnosis is made on the basis of a biopsy of a tumor and its histologic research.

Treatment of a neuroblastoma

Treatment of a neuroblastoma includes three main directions: use of chemotherapy, radiation therapy and operational method.

Carry usually out complex treatment of a neuroblastoma using several methods. The first and second stage of a neuroblastoma is successfully treated by means of operation. Though removal of a retroperitoneal neuroblastoma is not always possible because of germination of a tumor in the next fabrics and bonds with the main vessels. Sometimes perhaps partial oncotomy. Radiation therapy has good effect.

At the correct treatment probability of recovery at children with a neuroblastoma of the first and second stage – rather high. The fourth stage has the bad forecast of a disease, five-year survival even when using the most modern programs of treatment does not exceed 20%.