Diagnostic and prognostic impact of urinary catecholamines in neuroblastoma patients

Schmidt, Volker; Kerbl, Reinhold; Dornbusch, Hans Jürgen; Ladenstein, Ruth; Ambros, Peter F.; Ambros, Inge M.; Urban, Christian

doi:10.1002/pbc.20888

Cited by 125 publications

(89 citation statements)

References 35 publications

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“…If the patient had no history of cancer, the diagnosis of orbital metastasis should prompt a systemic survey to detect a primary neoplasm and other sites of metastasis. With the availability of tumor markers, certain specific outcomes may provide us valuable clues, for example, increased alpha-fetoprotein (AFP) variants suggest the origin of the liver [18], vanillylmandelic acid (VMA) hint to the neuroblastoma [19], prostate-specific antigen (PSA) [20] indicating prostate cancer, and a high level of 5-hydroxy oxindole indicating the carcinoid [21].…”

Section: Discussionmentioning

confidence: 99%

“…All patients came from the southern provinces of China. The left orbit was affected more frequently than the right, with a ratio of 3:2 (27: 19), and no cases were bilaterally involved. Before the detection of the orbital lesions, 22 patients had a definite primary tumor history, in which the nasopharyngeal carcinoma was the most frequent, accounting for 50% of the cases.…”

Section: General Datamentioning

confidence: 95%

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Metastatic orbital tumors in southern China during an 18-year period

Yan

Gao

2011

Graefes Arch Clin Exp Ophthalmol

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Section: Discussionmentioning

confidence: 99%

Section: General Datamentioning

confidence: 95%

Metastatic orbital tumors in southern China during an 18-year period

Yan

Gao

2011

Graefes Arch Clin Exp Ophthalmol

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“…12 If there is any question as to the diagnosis, this test should be performed and the results reviewed prior to surgery. The most surprising finding in the current investigation was that in children undergoing laparotomy for presumed WT, five patients actually had urinary VMA and/or HVA collected pre-operatively, indicating that NBL was entertained in the differential diagnosis.…”

Section: Discussionmentioning

confidence: 99%

Avoiding misdiagnosing neuroblastoma as Wilms tumor

Dickson

Sims

Streck

et al. 2008

Journal of Pediatric Surgery

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Purpose-Although occasionally difficult, distinguishing abdominal neuroblastoma (NBL) from Wilms tumor (WT) at presentation is important, as surgical management differs significantly. We reviewed our 20 year experience (1987)(1988)(1989)(1990)(1991)(1992)(1993)(1994)(1995)(1996)(1997)(1998)(1999)(2000)(2001)(2002)(2003)(2004)(2005)(2006) treating patients with NBL, focusing on those with an initial diagnosis of WT, to determine presenting features that would have suggested the correct pre-operative diagnosis.Methods-Retrospective case cohort study reviewing charts and imaging of patients with NBL initially diagnosed clinically with WT. Preoperative symptoms, laboratory studies, and imaging were evaluated. Similar variables were assessed in the 20 patients with WT most recently treated at our institution.Results-Nine patients with NBL were identified who had an exploratory laparotomy with a preoperative diagnosis of WT;eight underwent nephrectomy at exploration. Children with NBL had symptoms such as fever and weight loss at presentation (67%) more often than patients with WT (20%). Pre-operative computed tomography (CT) demonstrated intratumoral calcifications, vascular encasement, or both in 78% of patients with NBL but were never seen in WT patients. Of interest, pre-operative urinary catecholamines were elevated in five patients ultimately diagnosed with NBL.Conclusion-Although NBL can be mistaken for WT at presentation, the presence of constitutional symptoms, or intratumoral calcification or vascular encasement on preoperative imaging should heighten suspicion for NBL. In addition, laboratory evaluation, including urinary catecholamines, should be completed prior to surgery when the etiology of an abdominal tumor is uncertain.

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“…Biochemical studies included the assay of catecholamine metabolites, that is vanillylmandelic acid and homovanillic acid in the urine (Strenger et al, 2007), and lactate dehydrogenase (LDH) assay in the serum. Vanillylmandelic acid, homovanillic acid, and LDH levels were considered to be abnormal if they exceeded twice the upper normal value.…”

Section: Diagnostic Procedures and Metastatic Workupmentioning

confidence: 99%

Treatment of localised resectable neuroblastoma. Results of the LNESG1 study by the SIOP Europe Neuroblastoma Group

et al. 2008

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Main objective of this study was to confirm that surgery alone is an effective and safe treatment for localised resectable neuroblastoma except stage 2 with amplified MYCN gene (MYCNA). Of 427 eligible stages 1 -2 patients, 411 had normal MYCN and 16 had MYCNA. Of the 288 stage 1 patients with normal MYCN, 1 died of complications and 16 relapsed, 2 of whom died; 5-year relapse-free survival (RFS) and overall survival (OS) rates were 94.3% (95% confidence interval (CI): 91.6 -97) and 98.9% (95% CI: 97.7 -100), respectively. Of the 123 stage 2 patients with normal MYCN, 1 died of sepsis and 22 relapsed, 8 of whom died (RFS 82.8%, 95% CI: 76.2 -89.5; OS 93.2%, 95% CI: 88.7 -97.8). In stage 2, OS and RFS were worse for patients with elevated LDH and unfavourable histopathology. Of 16 children with MYCNA, 7 were stage 1 (5 relapses and 4 deaths) and 9 were stage 2 (3 relapses and 2 deaths) patients. In conclusion, surgery alone yielded excellent OS for both stage 1 and 2 neuroblastoma without MYCNA, although stage 2 patients with unfavourable histopathology and elevated LDH suffered a high number of relapses. Both stage 1 and 2 patients with MYCNA were at greater risk of relapse.

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Diagnostic and prognostic impact of urinary catecholamines in neuroblastoma patients

Cited by 125 publications

References 35 publications

Metastatic orbital tumors in southern China during an 18-year period

Metastatic orbital tumors in southern China during an 18-year period

Avoiding misdiagnosing neuroblastoma as Wilms tumor

Treatment of localised resectable neuroblastoma. Results of the LNESG1 study by the SIOP Europe Neuroblastoma Group

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