A Rare Adult Case with Neuroblastoma

George Imvrios, Dimitrios Filis, Ioannis Fouzas, Sofia Papadopoulou, Athanasios Kofinas, Eyaggelia Katsiki, Ioanna Dimitropoulou, Georgios Hahalis, Vasilios Papanikolaou

Abstract


Introduction: Neuroblastoma (NB) is the most common extracranial solid tumor in early childhood. According to the international bibliography it constitutes the 7-10% of all pediatric cancers, whereas it rarely occurs in adults. This neoplasm originates in the neural crest and it mainly arises from the adrenal medulla. Materials and Methods: A 26-year-old female presented to our emergency department (ED) with a palpable abdominal mass as the chief complaint. The imaging tests (ultrasound, CT, MRI) revealed a large lesion in the right lumbar region, which was pushing the right kidney and the right hepatic lobe without infiltrating either of them. Moreover, the inferior vena cava was displaced and compressed. The patient underwent investigative laparotomy and mass excision. The ipsilateral adrenal gland was also removed. The following histopathological examination of the mass showed that the tumor was neuroblastoma. Conclusion: NB is an aggressive tumor of the sympathetic nervous system, as it can infiltrate the surrounding tissues and spread via lymphatic and hematogenous dissemination. Its treatment is based on the pediatric guidelines due to its rare appearance in adults. Surgical therapy is the preferable treatment for stage 1-2Α patients, while chemotherapy and radiotherapy are usually given to stage 2B-3-4 patients.

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