Neuroblastoma in a 6-year-old boy

A previously healthy 6-year-old boy presented to the children's Accident and Emergency Department with right-sided abdominal pain. On examination, there was a palpable, non-tender abdominal mass, with no lymphadenopathy. Initial investigations revealed pancytopenia (haemoglobin was 5.7 g/dL, white cell count 3.7 x 109/L, platelets 134 x 109/L) and lactate dehydrogenase 1690 (normal range 240–480) with normal urea and electrolytes/liver function tests. Abdominal ultrasound showed a large central mass extending from the epigastrium to the level of the aortic bifurcation. A chest X-ray showed a fullness of the aortopulmonary window; this later was found to be extension of the tumour. MRI scanning confirmed a large lobulated solid mass lesion (figures 1 and 2). Figure 1Coronal section of the neuroblastoma tumour showing how the great vessels are encapsulated but not compressed. The crosses (+) mark the boundaries of the tumour. Figure 2Axial section of...
Source: Postgraduate Medical Journal - Category: General Medicine Authors: Tags: Emergency medicine, Journalology, Immunology (including allergy), Pain (neurology), Paediatric oncology, Screening (oncology), Radiology, Surgical diagnostic tests, General surgery, Radiology (diagnostics), Ethics Images in medicine Source Type: research