The medical history (history of the patient) represents an important component in the diagnosis of neuroblastoma. Family history Is there a frequent history of cancer in your family? Social history Current medical history/systemic history (somatic and psychological complaints). What symptoms have you noticed? How long have these changes existed? Does your child feel tired, weak? … Neuroblastoma: Medical History
Infectious and parasitic diseases (A00-B99). Infections, unspecified Neoplasms – tumor diseases (C00-D48). Neoplasms, unspecified
Pathogenesis (disease development) Neuroblastoma develops from immature neural cells in neurons of the sympathetic nervous system and in the adrenal gland. In a proportion of cases, the n-myc oncogene is amplified (multiplied). Etiology (Causes) The etiology is still unknown. Biographic causes Genetic burden from parents, grandparents (very rare). Genetic risk depending on gene polymorphisms: Genes/SNPs … Neuroblastoma: Causes
General measures Nicotine restriction (refraining from tobacco use). Limited alcohol consumption (men: max. 25 g alcohol per day; women: max. 12 g alcohol per day). Preservation of normal weight strive!Determination of BMI (body mass index, body mass index) or body composition using electrical impedance analysis. Falling below the BMI lower limit (from the age of … Neuroblastoma: Therapy
The following are the most important diseases or complications that may be contributed to by neuroblastoma: Neoplasms – Tumor Diseases (C00-D48). Metastases (daughter tumors); especially: Bone marrow Bone Liver Skin Lymph nodes Brain Lungs Central nervous system (CNS) Osteochondroma (benign bone tumor; associated with radiation therapy). Tumor recurrence – recurrence of neuroblastoma. Spontaneous tumor regression … Neuroblastoma: Complications
The International Neuroblastoma Staging System (INSS) distinguishes between the following disease stages: Stage Indicator 1 Localized tumor confined to site of originor tumor completely removed 2a Localized tumor infiltrates surrounding area without crossing midline, no lymph node involvementor Tumor infestation not completely removed only on one side of the spineNo lymph node involvement in the … Neuroblastoma: Classification
A comprehensive clinical examination is the basis for selecting further diagnostic steps: General physical examination – including blood pressure, pulse, body temperature, body weight, body height; further: Inspection (viewing). Skin, mucous membranes and sclerae (white part of the eye) [due tosymptoms: Paleness, sweating, hematomas (bruising) around the eyes, Horner’s syndrome (synonym: Horner’s triad) with unilateral … Neuroblastoma: Examination
1st order laboratory parameters – obligatory laboratory tests. Tumor markers NSE (neuron-specific enolase), homovanillic acid (HVS), vanillic mandelic acid (VMS). Laboratory parameters 2nd order – depending on the results of the history, physical examination and the obligatory laboratory parameters – for differential diagnostic clarification. Small blood count Inflammatory parameters – CRP (C-reactive protein). Liver parameters … Neuroblastoma: Test and Diagnosis
Therapeutic target Cure or improvement of prognosis Therapy recommendations Primary or neoadjuvant chemotherapy (NACT; before surgery) is given for cytoreduction (tumor size reduction) in initially inoperable tumors. Adjuvant (supportive) chemotherapy is used when the risk is intermediate (surgery with chemotherapy) or when the tumor could not be removed by surgery alone. Subsequent standard therapy consists … Neuroblastoma: Drug Therapy
Mandatory medical device diagnostics. Sonography (ultrasound examination) of the affected region. Computed tomography (CT; sectional imaging procedure (X-ray images taken from different directions with computer-based evaluation)) of the affected region (thorax/chest, abdomen/abdominal cavity, neck, head) Magnetic resonance imaging (MRI; computer-based cross-sectional imaging procedure (using magnetic fields, that is, without X-rays)) of the affected region (thorax/chest, … Neuroblastoma: Diagnostic Tests
The following procedures are usually used in combination in the treatment of neuroblastoma: In stages 1 and 2, surgical tumor removal alone is the goalOperation: tumor resection (the goal is complete removal of the tumor). Chemotherapy (in higher stages) before surgery. Radiotherapy (in stage 4 in selected tumor localizations). The following treatment concepts are available: … Neuroblastoma: Surgical Therapy
To prevent neuroblastoma, attention must be paid to reducing individual risk factors. Smoking during pregnancy Mothers of ill children were more likely to have smoked during pregnancy than controls (24.1 vs 19.7%; odds ratio [OR] 1.3; 95% confidence interval [95% CI] 0.9-1.7); when a meta-analysis was included, the data were just significant (OR 1.1; 95% … Neuroblastoma: Prevention
