1Description and features
- 1.1Neuroblastoma of adrenal glands in fetus and newborn
- 3Symptoms of the disease
- 4Stages of development of adrenal neuroblastoma in children
- 6Methods of treatment
- 7Prognosis and life expectancy
Neuroblastoma in children is more often affected by kidney tissue. Neuroblastoma of the right adrenal gland, as well as the left one, can give metastasis to the blood vessels, affect the lymph nodes, internal organs (for example, the liver) and affect the cells of the skin. This type of malignant neoplasm has unique characteristics and an aggressive form of development.
Description and features
There is a tumor of the adrenal gland with embryonic development and, as a rule, manifests itself at an early age. Development occurs due to pathological changes in immature embryonic nerve cells. Cells mutate and do not mature to a full level, while continuing to divide and form a tumor.
Neuroblastoma of the adrenal glands in children has a unique feature - in some cases disappears on its own.
The negative characteristic of neuroblastoma of the left and right adrenal glands in children is its aggressive and rapid development. Such a pathology of the adrenal glands in childhood is extremely rare and occurs up to 5 years. Occupies a rather large space in the abdominal region of the child. At the first stages of development, malignant formation is difficult to detect, it is possible only when carrying out a complex of studies.Back to contents
Neuroblastoma of adrenal glands in fetus and newborn
Children suffering from adrenal neuroblastoma do not have any symptoms of the disease. More often the tumor is found out casually at survey of the pediatrist or during carrying out of roentgenological and ultrasonic research. Malignant formation is characterized by rapid growth and in a short time can affect the canal of the spinal cord.
In the fetus, the development of adrenal neuroblastoma is extremely rare. When performing an ultrasound study of the fetus, neuroblastoma can be detected at the end of the 2nd trimester of pregnancy, the earliest tumor diagnosis was recorded at the 26th week. The fetus is usually localized on one side. It is practically impossible to predict the further development of the tumor after diagnosis, the course varies from independent regression to the active spread of metastases.Back to contents
The etiology and causes of the formation of the adrenal neuralblastoma in embryonic and childhood age has not yet been elucidated. In the vast majority of recorded cases, the tumor appears for no apparent reason. In more rare cases, this is a hereditary disease. Neuroblastoma of the adrenal gland as a hereditary form of cancer is found in newborns and infants under the age of 1 year.
Pathology occurs when the healthy maturation of embryonic cells changes. Mutation at the cellular level leads to inferior maturation of nerve cells, but they continue to divide, forming a malignant tumor. If the disease has occurred before the year, there is a chance that the tumor itself will flow into a benign form and disappear with time.Back to contents
Symptoms of the disease
At the first stages of the development of adrenal neuroblastoma, children do not show any characteristic symptoms. For childhood, minor malaise is seen as signs of other diseases characteristic of this period of life. The primary site of tumor localization, as a rule, is located in the adrenal gland.The baby can have cyanotic or red spots on the skin. This indicates the defeat of metastatic skin cells.The main characteristic symptoms in the presence of adrenal neuroblastoma in children:
- constant fatigue, drowsiness;
- increased sweating;
- increased body temperature for no apparent reason;
- enlarged lymph nodes, seals in the neck and abdomen;
- abdominal pain, upset of the stool;
- poor appetite, constant nausea, weight loss;
- pain in the bones.
Cancer cells produce hormones and provoke pressure on the organs. Increased malignant formation in the retroperitoneal space can negatively affect the functioning of the gastrointestinal tract. If the metastases reach the bone marrow, the child becomes painful and weak. Cuts, even minor, cause severe bleeding, which is difficult to stop.Back to contents
Stages of development of adrenal neuroblastoma in children
The course of development of the adrenal gland neuroblastoma has conditional stages. This division of the development of the disease makes it possible to determine the most effective methods of treatment. The 1st stage is characterized by a single tumor, the size of which (no more than 5 centimeters) allows to perform the operation. There are no metastases and lesions of the lymph nodes. Stage 2 - Malignant neoplasm is localized, part of it is operable. There are no metastases at all or no signs of distant metastases. 2 In the stage - the development of metastases that affect the lymph nodes.
3rd stage - a bilateral tumor appears. Neuroblastoma of the 3rd stage is divided in turn into several classifications: at a degree of T1 and T2 - single tumors not more than 5 centimeters and from 5 to 10 centimeters. N1 - lymph nodes are affected by metastases. M0 - there are no distant metastases. With the diagnosis of N, it is impossible to determine the presence or absence of metastases.
Stage 4 - malignant tumor increases in size, starts metastases in the bone marrow, internal organs and lymph nodes. Stage 4 has a tumor of not more than 10 centimeters, sometimes it is impossible to determine the presence or absence of metastases. Stage 4 B has many synchronous tumors. Define the defeat of lymph nodes is impossible, as well as assess the presence of distant metastases.Back to contents
If a neuroblastoma is suspected, the child should immediately consult a doctor and go through all the necessary examination procedures. Methods of diagnosis for the detection of adrenal neuroblastoma:
- urinalysis for the presence of oncomarkers and catecholamines;
- a common and expanded blood test;
- positron emission tomography;
- CT scan;
- biopsy of tumor and bone marrow tissue.
Primary diagnosis is carried out using urine and blood tests. If the suspicion of neuroblastoma is confirmed, additional studies are being performed that can reveal the site of its localization, the number of metastases, the size and nature of the tumor. Based on the results of the tests, the doctor prescribes the necessary treatment procedure.Back to contents
Methods of treatment
Methods of treating adrenal neuroblastoma in children are divided into 3 types: chemotherapy, radiation therapy and surgery. The choice of method depends on the stage of development of malignant neoplasm. At the 1 st and 2 nd stages, formations are usually removed by surgical intervention. If stage 2 B, after the operation, a course of chemotherapy is prescribed.Neuroblastoma of the 4S stage often disappears on its own.
The third stage of malignant formation is inoperable because of its large size. In this case, neuroblastoma is reduced by chemotherapy and then the necessary operation is performed. After the operation, the child must undergo radiation therapy. Unfortunately, the 4th degree of tumor development is difficult to treat and there is a high risk of death.Back to contents
Prognosis and life expectancy
At the initial stages of development of adrenal neuroblastoma in children is treatable in all cases. The third stage of proper treatment has a favorable prognosis - more than 65% of sick children successfully disposed of the tumor. Life expectancy after complete cure also has a favorable prognosis - the child can fully develop and live for many years. Stage 4S in 75% of cases successfully defeated by the child's body. When diagnosing neuroblastoma of the 4th stage, the prognosis is disappointing - no more than 20% of children live longer than 5 years after the treatment.