Neuroblastoma is a cancer of the sympathetic nervous system. In most cases, this disease is detected in young children. Timely detection of it can increase the chances of a final recovery. From the materials of this article you will learn the main causes of the pathology, what signs it is accompanied by, when treatment is required.
The surprising nature of neuroblastoma in a child
Neuroblastoma is the most common malignant tumor. It accounts for about 15% of all registered cases of neonatal neoplasms, as well as early childhood. Specialists usually detect a tumor in children under five years old, but there are cases of the disease in adolescents 11 and even 15 years old. As the child grows and develops, the likelihood of encountering this insidious disease decreases every year.
A neuroblast tumor, according to doctors, is endowed with amazing abilities. She is extremely aggressive andtendency to metastasize to any part of the body. Most often, the bone and lymphatic systems suffer from its vital activity. Sometimes doctors fix the growth of foci of neuroblasts, their division, followed by the formation of a tumor. It first gives metastases, and then stops its development and begins to regress. Malignant tumors of a different type are not characterized by such manifestations.
Neuroblastoma of the brain in children was first investigated by a German scientist, Rudolf Virchow in 1865. The doctor called the tumor a glioma. A few decades later, the American scientist James Wright studied the neoplasm in more detail and explained in detail the process of its formation.
Development of neuroblastoma by stages
Like any other oncological neoplasms, neuroblastoma in children goes through several conditional stages of development, the definition of which allows you to prescribe effective treatment:
- Stage 1. Characterized by the presence of an operable tumor, the size of which does not exceed 5 cm, and the absence of metastases in the lymph nodes.
- Stage 2A. Indicates a localized tumor, most of which needs to be removed.
- Stage 2B. There is a metastatic lesion of the lymph nodes unilaterally.
- Stage 3. Characterized by the appearance of a bilateral tumor.
- Stage 4 (A-B). The neoplasm grows, metastasis to the bone marrow, liver and lymph nodes is observed.
Separately, we should consider how neuroblastoma develops in children at the last stage. Stage 4 is differentbiological characteristics not characteristic of other neoplasias, has a good prognosis, and with timely treatment gives a high percentage of survival.
Main causes of tumor development
Neuroblastoma, like other types of cancer, develops against the background of genetic mutations in the body. Currently, experts cannot say what exactly gives impetus to these changes. It is assumed that so-called carcinogenic factors, that is, chemicals and radiation, play a role. The cells resulting from mutations begin to multiply rapidly, forming a tumor. A malignant neoplasm is characterized by the ability to divide, which distinguishes it from a benign one.
The mutation that provokes the formation of neuroblastoma occurs during the period of intrauterine development of the fetus or immediately after the birth of the child. Therefore, most patients are infants. The origin of the tumor begins in neuroblasts. These are immature nerve cells that are formed in the fetus during its intrauterine development. During normal pregnancy, neuroblasts take over the functions of nerve fibers or become cells responsible for the formation of the adrenal glands.
By the time a child is born, most of them have already been formed. Immature cells usually disappear. In the pathological course of this process, neuroblasts turn into a tumor. The only confirmed factor in the occurrence of cancer is a genetic predisposition. However, the riskhereditary development of the disease does not exceed 2%.
Most often, doctors diagnose retroperitoneal neuroblastoma, the favorite localization area of which is the adrenal glands. Theoretically, the tumor can occur in any part of the body. Neuroblastoma of the retroperitoneal space in children occurs in 50% of cases, in 30% of patients the neoplasm develops from the nerve knots of the lumbar region, in the remaining 20% it chooses the cervical and thoracic regions for localization.
How does a tumor manifest?
At the initial stage of the pathological process, there are no specific symptoms. Therefore, the tumor is often perceived as other diseases characteristic of this age.
Signs of neuroblastoma in children appear depending on the location of the neoplasm, areas of spread of metastases and the level of vasoactive substances. Usually the primary site of the tumor is located in the retroperitoneal space, more precisely in the adrenal glands. In rare cases, it is localized in the neck or in the mediastinum.
How does neuroblastoma manifest in children? Symptoms of the disease are due to the release of hormones by cancer cells or the constant pressure of the neoplasm on one or another organ. Sometimes its growth affects the functioning of the intestines and bladder. Due to squeezing of blood vessels, patients experience swelling of the scrotum and lower extremities.
Reddish or bluish spots on the skin are also signs of neuroblastoma in a child. Their appearance signals the involvement of cells in the pathological process.epidermis. When the tumor penetrates directly into the bone marrow, the baby becomes weak, often sick. In this case, even a small wound can lead to extensive bleeding.
Noticing the symptoms of neuroblastoma, parents should see a doctor. Early detection of cancer can save a child's life.
Retroperitoneal neuroblastoma
A neoplasm from tissues of neurogenic origin, which occurs in the retroperitoneal space, is characterized by rapid growth. In a short period of time, it penetrates into the spinal canal, forming a dense tumor that can be detected by palpation.
Adrenal neuroblastoma in children initially has no specific symptoms until it reaches an impressive size and begins to attach adjacent tissues. What are the signs of a tumor?
- Presence of a dense mass in the abdominal cavity.
- Puffiness of the whole body.
- Discomfort and pain in the lumbar region.
- Weight loss.
- Temperature increase.
- Changes in blood counts indicating anemia.
- Numbness, paralysis of the lower extremities.
- Disorder of the functional abilities of the gastrointestinal tract and excretory system.
Other localizations of neurogenic tumors
Neuroblastoma of the posterior mediastinum in children is accompanied by a sharp weight loss, difficulty swallowing, respiratory distress. In some cases, illnessleads to a change in the shape of the chest.
Tumors of the extraocular space are extremely rare, but more is known about them. This is due to the fact that all signs of the pathological process are visible to the naked eye. The neoplasm is characterized by the appearance of a dark spot on the eye, which looks like an ordinary bruise. Another symptom of neuroblastoma is a droopy eyelid. It covers an unnaturally protruding eyeball.
Shapes of neuroblastoma
Currently, experts distinguish four forms of neuroblastoma, each of which has a specific location and distinctive characteristics.
- Medulloblastoma. The neoplasm originates deep in the cerebellum, which is why its removal is impossible through surgical intervention. Pathology is characterized by rapid metastasis. The very first symptoms of the tumor are manifested by impaired coordination of movements.
- Retinoblastoma. This is a malignant tumor that affects the retina in young patients. Lack of treatment leads to total blindness and brain metastasis.
- Neurofibrosarcoma. This tumor is localized in the abdominal cavity.
- Sympathoblastoma. This is a tumor of a malignant nature, which chooses the sympathetic nervous system and adrenal glands as its "home". A neoplasm is formed in the fetus during its intrauterine development. Due to the rapid increase in the size of sympathoblastoma, the spinal cord can be affected, which leads to paralysis of the limbs.
How to recognize neuroblastoma?
Initially, the doctor prescribes a blood and urine test if a diagnosis of neuroblastoma is suspected. In children, the symptoms of this pathology are similar to other diseases, and a laboratory study of biological materials makes it possible to exclude other possible causes. High levels of catecholamine hormones in the urine indicate the presence of oncology.
To determine the size of the tumor, its localization, small patients are prescribed CT, ultrasound and MRI. Biopsy is an important diagnostic method. During this procedure, a specialist collects cancer cells for their subsequent study in the laboratory, conducting a histological analysis.
Based on the results of the tests, the doctor develops treatment tactics, gives recommendations on the regimen and lifestyle of the patient.
Therapy options
Treatment of neuroblastoma in a child is usually carried out simultaneously by several specialists of the oncology department (chemotherapist, surgeon, radiologist). After studying the characteristics of the tumor, doctors develop tactics for its destruction. It depends on how the neoplasm reacts to the measures taken, and on the prognosis at the time of the final diagnosis.
Typically, the treatment of neuroblastoma in children includes the following methods:
- Chemotherapy. This procedure involves the introduction of anticancer drugs according to specially designed schemes. The drugs have a detrimental effect on cancer cells, preventing their reproduction. Other parts of the body suffer along with them,leading to common side effects (hair loss, nausea, diarrhea). The effectiveness of the therapy is increased several times in combination with brain transplantation.
- Surgical treatment involves the removal of the neoplasm. Chemotherapy is given before the operation. It allows you to slow down the growth of the tumor and lead to the regression of metastases. The admissibility of its complete removal depends on the localization and size. A small growth near the spinal cord makes the intervention very risky.
- Radiotherapy is rarely used in modern medical practice. It is increasingly being replaced by surgical intervention, since radiation is unsafe and carries a certain threat to the life of the child. Radiation therapy is recommended strictly according to indications, when there is a lack of effectiveness of other methods of treatment, in the case of inoperable neuroblastoma in a child.
A special diet for this diagnosis is not prescribed for small patients. Many parents, trying to fight in every possible way for the life of their child, adjust his diet. It has been proven that some products, more precisely, the substances they contain, increase the body's defenses and significantly slow down tumor growth. These substances include zinc, iron, betaine, various vitamins. They are rich in citrus fruits, young greens, carrots, pumpkin.
The success of any therapy depends on the size of neuroblastoma in children. Causes of pathology and stagesdiseases also matter. The use of radical methods at the initial stages of tumor formation gives hope for a full recovery. However, this does not exempt a small patient from visiting a doctor and undergoing an examination in order to prevent a possible relapse.
The possibility of a final recovery is not excluded in the second stage, subject to a successful operation and chemotherapy.
Certain difficulties arise in the last stages of the development of such a pathology as neuroblastoma. In children, stage 4 cancer usually comes with a poor prognosis. Relapse is possible after removal of the tumor, against the background of a seeming recovery. The next formation of a malignant nature usually forms in the same place where it was before. The prognosis at this stage is 20% survival within five years. In this case, everything depends on the qualifications of specialists, the availability of the necessary medical equipment.
Forecast
After intensive oncology therapy, the prognosis for most patients is favorable. In children with a localized tumor process, doctors note a high probability of recovering as soon as possible. As for this category of patients, the neoplasm may disappear even without surgical intervention, but intensive drug therapy in this case is mandatory. Older children with advanced tumors have a much lower chance of definitive recovery. Moreover, the neoplasm may reappear.
The consequence of treatment is often a secondaryneuroblastoma in children. The prognosis in this case is not the most favorable. The tumor may appear again after several years, including after successful treatment. This kind of consequences in medicine is called a belated side effect. That is why all patients, without exception, after a course of therapy, it is recommended to be observed by doctors constantly.
Prevention measures
Doctors do not give any specific recommendations regarding the prevention of the development of a malignant tumor, since the causes of its formation remain poorly understood, with the exception of an alleged hereditary predisposition. If close relatives have ever had to deal with this insidious diagnosis, it is advisable to visit a geneticist during pregnancy planning. It will probably help to avoid the anxiety associated with the birth of an unhe althy child in the future.
Unfortunately, oncological diseases today are increasingly being diagnosed in young patients, and neuroblastoma in children is no exception. Photos of pathology can be viewed in specialized medical reference books. Physicians cannot offer specific methods of prevention due to the unclear etiology of the pathology. With the appearance of primary symptoms indicating this ailment, it is extremely important to seek help from a doctor. Only after passing a complete diagnostic examination can one judge the nature of the neoplasm and develop an approximate treatment strategy. The sooner the specialist confirms the finaldiagnosis, the higher the chances of a full recovery. Stay he althy!
