A Review of Infants With Localized Neuroblastoma That Evolve to Stage 4s Disease.
Anna M Caroleo, Bruno De Bernardi, Stefano Avanzini, Anna R Gigliotti, Monica Muraca, Elvira Pota, Massimo Provenzi, Katia Mazzocco, Angela R Sementa, Claudio Granata, Stefania Sorrentino
Author Information
Anna M Caroleo: Departments of Hematology/Oncology.
Bruno De Bernardi: Departments of Hematology/Oncology.
Stefano Avanzini: Surgery.
Anna R Gigliotti: Epidemiology and Biostatistics Unit.
Monica Muraca: Departments of Hematology/Oncology.
Elvira Pota: Hematology/Oncology Unit, Pediatric Department, Vanvitelli University, Napoli.
Massimo Provenzi: Department of Pediatrics, Civic Hospital, Bergamo, Italy.
Katia Mazzocco: Pathology Unit, IRCCS Istituto Giannina Gaslini, Genova.
Angela R Sementa: Pathology Unit, IRCCS Istituto Giannina Gaslini, Genova.
Claudio Granata: Radiology.
Stefania Sorrentino: Departments of Hematology/Oncology.
The authors describe a newborn diagnosed with localized neuroblastoma that evolved to stage 4s at the age of 5 months. Peculiar features of the case included a bilateral adrenal primary, the skin as the only metastatic site, and the development of a muscular lesion late in the clinical course. The patient underwent left adrenalectomy and all other lesions regressed without further therapy. The case prompted a search for similar cases both in the Italian Neuroblastoma Registry and in the literature. All patients identified, although variously treated, survived with the exception of the 2 with MYCN gene amplification. We conclude that infants with neuroblastoma who undergo a transition from a localized to stage 4s disease could be less rare than expected. In the absence of unfavorable biology, a wait-and-see policy with strict follow-up could be adopted for these patients, avoiding potentially damaging systemic therapy.
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