Neuroblastoma is a cancer of the sympathetic nervous system. In most cases, this ailment is detected in young children. Its timely detection allows you to increase the chances of a final recovery. From the materials in this article you will learn the main causes of the pathology, what signs it is accompanied when treatment is required.
The amazing nature of neuroblastoma in a child
Neuroblastoma is the most common tumor of a malignant nature. It accounts for about 15% of all recorded cases of neoplasms of the neonatal period, as well as early childhood. Specialists usually detect a tumor in children under five years of age, but cases of the disease are known in adolescents 11 and even 15 years old. As the child grows and develops, the probability of encountering this insidious disease decreases every year.
According to doctors, a neuroblast tumor is endowed with amazing abilities. It is particularly aggressive and prone to metastasis to any part of the body. Most often, the bony and lymphatic systems suffer from her life. Sometimes doctors record the growth of foci of neuroblasts, their division, followed by the formation of a tumor. She first gives metastases, and then stops her development and begins to regress. Malignant formations of a different type are not characterized by such manifestations.
Brain neuroblastoma in children was first studied by a scientist from Germany, Rudolf Virchow in 1865. The doctor called the tumor "glioma." After several decades, the American scientist James Wright studied the neoplasm in more detail and explained in detail the process of its formation.
The development of neuroblastoma in stages
Like any other oncological neoplasms, neuroblastoma in children goes through several conditional stages of development, the determination of which allows you to assign an effective treatment:
- Stage 1. It is 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. It indicates a localized tumor, most of which must be removed.
- Stage 2B. There is a metastatic lesion of the lymph nodes unilaterally.
- Stage 3. It is characterized by the appearance of a bilateral tumor.
- Stage 4 (AB). The neoplasm grows, metastasis to the bone marrow, liver and lymph nodes is observed.
Separately, it should be considered how at the last stage a neuroblastoma develops in children. Stage 4 is characterized by biological characteristics not characteristic of other neoplasias, it has a good prognosis, and with timely treatment it gives a high survival rate.
The main causes of tumor development
Neuroblastoma, like other types of oncology, 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 a certain role is played by the so-called carcinogenic factors, that is, chemicals and radiation. The cells resulting from mutations begin to multiply rapidly, forming a tumor. Malignant neoplasm is characterized by the ability to share, which distinguishes it from benign.
A mutation that provokes the formation of a neuroblastoma occurs even during fetal development or immediately after the birth of a child. Therefore, most patients are infants. The nucleation of a tumor begins in neuroblasts. These are immature nerve cells that form in the fetus during its intrauterine development. In the normal course of pregnancy, neuroblasts assume 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. Unripe cells usually disappear. With the pathological course of this process, neuroblasts turn into a tumor. The only confirmed factor for the occurrence of cancer is a genetic predisposition. However, the risk of hereditary development of the disease does not exceed 2%.
Most often, doctors diagnose retroperitoneal neuroblastoma, a favorite area of ​​localization of which is the adrenal glands. Theoretically, a tumor can occur in any part of the body. Retroperitoneal neuroblastoma in children occurs in 50% of cases, in 30% of patients the neoplasm develops from nerve nodules of the lumbar region, in the remaining 20% ​​it selects the cervical and thoracic regions for localization.
How does the tumor appear?
At the initial stage of the onset of the pathological process, specific symptoms are not observed. Therefore, the tumor is often perceived for other diseases characteristic of this age.
Signs of neuroblastoma in children are manifested depending on the location of the neoplasm, the areas of metastasis and the level of vasoactive substances. Usually the primary node of the tumor is located in the retroperitoneal space, more precisely in the adrenal glands. In rare cases, it is localized on the neck or in the mediastinum.
How is neuroblastoma manifested 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 compression of the blood vessels in patients, swelling of the scrotum and lower extremities occurs.
Reddish or bluish spots on the skin are also signs of a child’s neuroblastoma. Their appearance signals the involvement of epidermal cells in the pathological process. With the penetration of the tumor directly in the bone marrow, the baby becomes weak, often sick. In this case, even a small wound can lead to extensive bleeding.
Having noticed the symptoms of neuroblastoma, parents should consult a doctor. Early detection of cancer can save a child’s life.
Retroperitoneal neuroblastoma
A neoplasm from tissues of neurogenic origin that 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 with a consistency, which can be detected by palpation.
At first, adrenal neuroblastoma in children does not have specific symptoms until it reaches an impressive size and begins to attach adjacent tissues. What are the signs of a tumor?
- The presence of a dense formation in the abdominal cavity.
- Puffiness of the whole body.
- Discomfort and pain in the lumbar region.
- Weight loss.
- Temperature rise.
- Change in blood counts indicating anemia.
- Numbness, paralysis of the lower extremities.
- Disorder of the functional abilities of the digestive tract and excretory system.
Other localization of tumors of neurogenic origin
Neuroblastoma of the posterior mediastinum in children is accompanied by sharp weight loss, difficulty swallowing, and respiratory distress. In some cases, the ailment leads to a change in the shape of the chest.
Tumors of the eye space are extremely rare, but they know more about them. This is due to the fact that all the 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 a neuroblastoma is a lowered eyelid. It covers an unnaturally bulging eyeball.
Neuroblastoma Forms
Currently, experts identify four forms of neuroblastoma, each of which has a specific location and distinctive characteristics.
- Medulloblastoma. The neoplasm originates deep in the cerebellum, due to which its removal is impossible through surgical intervention. Pathology is characterized by rapid metastasis. The very first symptoms of a tumor are manifested by impaired coordination of movements.
- Retinoblastoma. This is a malignant tumor that affects the retina of small patients. Lack of treatment leads to total blindness and metastasis to the brain.
- Neurofibrosarcoma. This tumor is localized in the abdominal cavity.
- Sympatoblastoma. This is a tumor of a malignant nature, which selects 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 a 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 allows us to exclude other possible causes. High rates of catecholamine hormones in the urine indicate the presence of oncology.
To determine the size of the tumor, its localization, CT, ultrasound and MRI are prescribed to small patients. An important diagnostic method is a biopsy. During this procedure, a specialist makes a sampling of cancer cells for subsequent study in laboratory conditions, histological analysis.
Based on the results of the analysis, the doctor develops treatment tactics, gives recommendations on the regimen and lifestyle of the patient.
Therapy options
The 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 responds to ongoing activities, and on the prognosis at the time of establishing the final diagnosis.
Typically, treatment of neuroblastoma in children includes the following methods:
- Chemotherapy. This procedure involves the introduction of anticancer drugs according to specially developed schemes. 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 removal of the neoplasm. Before surgery, chemotherapy is used. It allows you to slow down tumor growth and lead to regression of metastases. The admissibility of its complete removal depends on the location and size. A small neoplasm located near the spinal cord makes the intervention very risky.
- Radiation therapy is rarely used in modern medical practice. It has been increasingly replaced recently by surgical intervention, since radiation exposure is unsafe and poses a certain threat to the life of the child. Radiation therapy is recommended strictly according to the indications, when there is a low efficiency of other methods of treatment, in the case of inoperable neuroblastoma in a child.
A special diet with this diagnosis is not prescribed for small patients. Many parents, trying to fight in every possible way for the life of a child, adjust his diet. It is proved that some products, more precisely, the substances contained in them, 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 herbs, carrots, pumpkin.
The success of any therapy depends on the size of the neuroblastoma in children. The causes of the pathology and stage of the disease also matter. The use of radical methods in the initial stages of tumor formation gives hope for a complete recovery. However, this does not exempt the small patient from visiting a doctor and undergoing an examination in order to prevent a possible relapse.
The likelihood of a final recovery is not excluded in the second stage, provided that the operation and chemotherapy have been successfully carried out.
Certain difficulties arise at the last stages of the development of such a pathology as neuroblastoma. In children, stage 4 cancer is usually accompanied by disappointing prognoses. Relapse is possible after removal of the tumor, against the backdrop of seemed recovery. Another formation of a malignant nature usually forms in the same place as before. The prognosis at this stage is 20% survival for five years. In this case, it all depends on the qualifications of the specialists, the availability of the necessary medical equipment.
Forecast
After intensive care of oncology, the prognosis in most patients is favorable. In children with a localized tumor process, doctors note a high probability of recovering in the shortest possible time. As for this category of patients, the neoplasm can disappear even without surgical intervention, but intensive drug therapy in this case is mandatory. In older children with a spreading tumor, the chances of a final recovery are much lower. Moreover, the neoplasm may occur again.
The consequence of treatment is often secondary neuroblastoma in children. The prognosis in this case is not the most favorable. A tumor may appear again several years later, including after successful treatment. These kinds of consequences in medicine are called delayed side effects. That is why it is recommended that all patients, without exception, after a course of therapy be observed by doctors constantly.
Preventive actions
Doctors do not give any specific recommendations regarding the prevention of the development of a tumor of a malignant nature, since the reasons for its formation remain poorly understood, with the exception of the alleged hereditary predisposition. If close relatives have ever had to deal with this insidious diagnosis, it is advisable to consult a genetic doctor during pregnancy planning. Probably, he will help in the future to avoid unrest associated with the birth of an unhealthy child.
Unfortunately, oncological diseases today are increasingly diagnosed in small patients, neuroblastoma in children is no exception. Photos of the pathology can be found in specialized medical guides. Doctors cannot offer specific methods of prevention because of the unclear etiology of the pathology. When primary symptoms appear that indicate this ailment, it is extremely important to seek medical help. Only after passing a full diagnostic examination can we judge the nature of the neoplasm and develop an approximate treatment tactic. The sooner the specialist confirms the final diagnosis, the higher the chances of a full recovery. Be healthy!