Tuesday, January 15, 2008

How to Treat Neuroblastoma


Neuroblastoma is a tumor arising from immature nerve cells. It is the most malignant tumor of the abdomen in infants and the most common solid tumor in children not affecting the brain. A neuroblastoma is one of the few malignancies where a positive prognosis can be achieved when residual tumor has been left. It is also unusual in that a neuroblastoma can self-resolve. Read on to learn more about how to treat neuroblastoma.


Difficulty: Challenging



Step One

Use chemotherapy for advanced stage neuroblastomas. Infants receiving chemotherapy and surgery for disseminated neuroblastomas have favorable outcomes, but children older than one year have poor survival rates. The most common chemotherapeutic agents are cisplatin, cyclophosphamide, doxorubicin, etopsice and teniposide.

Step Two

Perform surgery as the treatment of choice on low and intermediate stage neuroblastomas. The objectives of surgery are to confirm the diagnosis, remove the entire tumor and provide surgical staging. Secondary surgeries also are performed as adjuvant therapy and to remove any residual tumor.

Step Three

Conduct a thorough patient history and physical examination. It is essential that all imaging studies be reviewed and complete blood chemistries run before attempting to remove a neuroblastoma. Other patient-specific studies must be done.

Step Four

Remove the neuroblastoma surgically. It is essential that the tumor be adequately exposed during surgery. This is best accomplished with a midline transperitoneal incision for most abdominal neuroblastomas. A wedge biopsy should be taken if the tumor is not operable.

Step Five

Provide the usual postoperative management for major abdominal surgery. Problems related to vascular injury are the most common complications of removing a neuroblastoma.

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