Neuroblastoma
A childhood cancer that begins in early nerve cells, often near the adrenal glands
Quick Facts
- Type: Childhood cancer (solid tumor)
- Who it affects: Mostly infants and young children
- Common starting point: Adrenal glands and nerve tissue near the spine
- Outlook: Varies widely by age and tumor features
Overview
Neuroblastoma is a cancer that arises from immature nerve cells (neuroblasts) that are left over from a baby's development. It is one of the most common solid cancers in young children and most often occurs in those under five years old. It is rare in older children and adults.
The tumor usually begins in the adrenal glands, which sit on top of the kidneys, but it can start anywhere along the chain of nerve tissue that runs near the spine, including the chest, neck, abdomen, or pelvis. Neuroblastoma behaves very differently from case to case: some tumors mature or disappear on their own, especially in infants, while others grow and spread aggressively and need intensive treatment.
Symptoms
Symptoms depend on where the tumor is and whether it has spread, and they can be easy to mistake for more common childhood illnesses.
- A lump or swelling in the abdomen, chest, or neck
- Abdominal pain, fullness, or loss of appetite
- Bone pain, limping, or refusing to walk if the cancer has spread to bone
- Fatigue, weakness, or unexplained weight loss
- Fever and irritability
- Bruising or dark circles around the eyes
- Back pain or weakness in the legs if a tumor presses on the spinal cord
Less commonly, certain tumors cause jerky eye movements and unsteadiness, or high blood pressure, sweating, and a fast heartbeat.
Causes
Neuroblastoma develops when neuroblasts, the immature nerve cells of a developing baby, fail to mature normally and instead grow out of control. In most cases the exact reason is unknown, and there is nothing the parents did or could have done to cause it.
A small number of cases are linked to inherited gene changes that run in families, but the great majority occur by chance and are not inherited. Because it arises from early developmental cells, the cancer is largely a disease of very young children.
Risk Factors
- Young age, with most cases occurring in children under five
- A family history of neuroblastoma, which accounts for a small minority of cases
- Certain inherited genetic conditions in rare instances
For most children, no clear risk factor is found, and the cancer is not linked to anything the family did.
Diagnosis
Diagnosing neuroblastoma involves locating the tumor, confirming the cell type, and finding out whether it has spread. Tests may include:
- Imaging: Ultrasound, CT, or MRI scans to find and measure the tumor, and specialized nuclear scans to detect spread.
- Biopsy: Removing a sample of the tumor to confirm the diagnosis and study its features under a microscope and in the laboratory.
- Urine and blood tests: Many neuroblastomas release chemicals that can be measured in the urine or blood.
- Bone marrow tests: To check whether the cancer has reached the bone marrow.
The results are used to assign a stage and risk group, which guide treatment.
Treatment
Treatment is tailored to the child's age, the stage of the cancer, and specific tumor features, and is usually delivered by a specialized children's cancer team.
- Observation: Some low-risk tumors in infants are watched closely, as they may mature or shrink on their own.
- Surgery: To remove the tumor when possible.
- Chemotherapy: Medicines that kill cancer cells, used for higher-risk or widespread disease.
- Radiation therapy: Targeted treatment to destroy remaining cancer cells.
- Stem cell transplant and immunotherapy: Used in high-risk cases as part of intensive combined treatment.
The outlook varies widely. Low-risk neuroblastoma often has an excellent outcome, while high-risk disease requires intensive, multi-part treatment.
Prevention
There is no known way to prevent neuroblastoma, because it arises from early nerve cells during a baby's development and the cause is usually unknown. It is not linked to anything parents did during pregnancy or after birth.
- Families with a known inherited form may be offered genetic counseling
- Early evaluation of unexplained lumps or persistent symptoms in a young child supports prompt diagnosis
When to See a Doctor
Contact your child's doctor if you notice an unexplained lump or swelling, ongoing abdominal pain, persistent fatigue or weight loss, bone pain or limping, or any worrying change that does not improve.
Seek urgent care if your child develops sudden weakness in the legs, difficulty walking or standing, loss of bladder or bowel control, or severe pain, as a tumor pressing on the spinal cord needs prompt evaluation.
Frequently Asked Questions
What age does neuroblastoma usually affect?
Neuroblastoma occurs mainly in infants and young children, with most cases diagnosed before age five. It is uncommon in older children and rare in adults, because it arises from immature nerve cells left over from early development.
Is neuroblastoma curable?
The outlook depends heavily on the child's age and the tumor's features. Low-risk neuroblastoma often has an excellent outcome and may even resolve on its own, while high-risk disease needs intensive treatment and has a more variable outcome.
Is neuroblastoma inherited?
Most cases are not inherited and happen by chance. A small number run in families due to inherited gene changes, and those families may be offered genetic counseling. Parents do not cause the cancer.
How is neuroblastoma diagnosed?
Doctors use imaging scans to locate the tumor, a biopsy to confirm the cell type, and blood, urine, and bone marrow tests to check for spread. These results determine the stage and risk group, which guide treatment.
What are common first signs?
Common early signs include a lump or swelling in the abdomen, chest, or neck, ongoing abdominal pain or poor appetite, fatigue, and bone pain or limping. These can resemble other childhood illnesses, so persistent or unexplained symptoms should be checked.
References
- National Cancer Institute (NCI). Neuroblastoma Treatment.
- American Cancer Society. Neuroblastoma.
- St. Jude Children's Research Hospital. Neuroblastoma.
- MedlinePlus, U.S. National Library of Medicine. Neuroblastoma.