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Methtrexate Neurotoxicity
Joseph Junewick, MD FACR
over 6 years ago
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Neuroblastoma - Stage 4S

Case Detail

Anatomy: Genitourinary
Junewick
Joseph Junewick, MD FACR
Diagnostic Category: Neoplasia Malignant
Created: over 6 years ago
Updated: over 6 years ago
Tags: PEDS
Modality/Study Types: US CT
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History

3 month old female with abdominal distention.


Case Images


Diagnosis

Neuroblastoma

Findings

US – Circumscribed hyperechoic right suprarenal mass with diffuse hepatic metastatic disease.

CT – Right adrenal mass with massive hepatomegaly with diffuse metastatic disease; no retroperitoneal adenopathy.

Discussion

Pathology and staging are essential to determine therapy and risk group. Numerous staging systems have been employed. While all provided similar prognostic information, the International Neuroblastoma Staging System was developed to give uniformity for clinical trials around the world.

Stasge 1 – Tumor confined to organ/region of origin. Complete gross excision and/or microscopic residual disease. Microscopically negative lymph nodes not attached to primary tumor.

Stage 2A – Unilateral tumor with incomplete gross excision. Microscopically negative lymph nodes not attached to primary tumor.

Stage 2B – Unilateral tumor with complete or incomplete excision. Positive ipsilateral lymph nodes. Microscopically negative contralateral lymph nodes.

Stage 3 – Midline with or without regional lymph node involvement. Unilateral tumor with contralateral lymph node involvement. Midline tumor with bilateral lymph node involvement.

Stage 4 – Dissemination to distant lymph nodes and organs.

Stage 4S – Localized primary tumor (Stage 1 or 2). Dissemination limited to skin, bone marrow and/or liver.

Reference

Brodeur GM, Castleberry RP. Neuroblastoma, in Principles and Practice of Pediatric Oncology 2nd Ed. JB Lippincott Co.



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