Neuroblastoma

What is Neuroblastoma?

Neuroblastoma is a malignant tumor that is most often found in young children and originates from the sympathetic nervous system. Neuroblastomas can occur in places where sympathetic nerve tissues are located. The most common place where they are seen is the adrenal gland. In some patients, metastases may occur in the bone marrow, bone, distant lymph nodes, liver or skin, and rarely in the brain or lung. The cause of neuroblastoma formation is not yet fully known. Many genetic changes have been detected in neuroblastoma tumor cells.

How is Neuroblastoma Diagnosed?

Laboratory tests play an important role in making the diagnosis. In the blood or urine of most patients with neuroblastoma, some body-specific substances defined as tumor markers are found in high values. Some of the tumor markers considered important in neuroblastomas are catecholamines and the substance neuron-specific enolase (NSE). Imaging methods are used in the diagnosis. With the help of ultrasonography, the location and size of most neuroblastomas can be determined. A magnetic resonance tomography (MRI) is also performed to find very small tumors and to determine whether they have spread to the formations around them. In order to better assess the metastases and the primary tumor, MIBG scintigraphy can be performed briefly by using 123 iodine-meta-iodobenzylguanine, which contains a radioactive substance. Alternatively, radioactive (FDG) positron emission tomography (PET) is used. A bone marrow sample should be taken from each patient and examined. This procedure is performed under short-term anesthesia. The sample taken is examined under a microscope. Sampling of the tumor tissue usually takes place through surgical intervention. Molecular genetic examinations to be performed on the received tissue give information about the degree of malignancy of the tumor. Depending on the type of treatment planned to be performed, additional examinations are performed to check the condition and October functions of some organs before the treatment has even begun. These examinations may be: heart examination before chemotherapy (electrocardiography [ECG], echocardiography), hearing examination (audiometry), kidney function tests or kidney ultrasonography.

 How is the Treatment of Neuroblastoma?

After the diagnosis is finalized, treatment is planned. It is very important at which stage of the disease the patient is located. The treatment of children with neuroblastoma should be carried out by pediatric oncology centers. Treatment is arranged according to the stage of the patient’s disease. In some patients, only surgical removal of the tumor or taking only a biopsy sample from the tumor may be sufficient, while in other patients, various treatment methods must be used together in order to increase recovery rates.

The treatment methods that can be used in neuroblastoma are surgery, chemotherapy and radiotherapy. In addition, autologous stem cell transplantation and immunotherapy with antibodies are also performed in patients with a very high risk of recurrence of the disease, following high October chemotherapy. In addition, radioactive marked methyliotbenzylguanidine therapy (MIBG therapy) or retinoic acid maturation therapy can also be used in these patients.

The purpose of the operation is to completely remove the tumor and/or to take a tissue sample from the tumor. In chemotherapy, drugs are used that prevent cell division and thus allow the cell to die. In general, drugs with different mechanisms of action are used Decombustly in order to cause the greatest possible damage to malignant cells. A more intense treatment with high-dose chemotherapy: this treatment is only the cancer cells but also in bone marrow blood cells [stem cells] it can kill, therefore must be made by autologous stem cell transplant after this treatment. In some patients, radiotherapy may be required. Thus, the reproductive properties of tumor cells are damaged, allowing them to die.