Paediatric neuroblastoma presenting as an asymptomatic abdominal mass: a report on the importance of a complete clinical examination with a view to a timely diagnosis and therapeutic guidance in paediatric oncology

Abstract

Neuroblastoma (NB) is the most common extracranial solid tumour in children after lymphoblastic leukaemias, brain tumours and lymphomas.We report a case of an NB in a previously healthy toddler. Though she had no abdominal complaints, on physical examination, she had a palpable mass identified over the right upper portion of the abdomen. Imaging studies demonstrated a heterogeneous tumour with an irregular capsule and visible calcifications.After initial diagnosis, the patient underwent chemotherapy and was subjected to a radical resection of the tumour 4 months later. One-year follow-up of the patient showed no recurrence.In children, oncological diseases are often asymptomatic or have non-specific symptoms, and in remote locations where specialised/paediatric services may not be available, the importance of medical training in paediatrics is highlighted, with emphasis on performing a complete clinical examination, namely abdominal palpation. The role of timely referral will be evident in such a situation.

Toddler with giant omental cyst, profound anemia, and shock: case report and review of the literature

“…Although imaging studies, including point-of-care ultrasonography, CT scan, and magnetic resonance imaging, are vital for the diagnosis of intra-abdominal cysts, they may fail to differentiate giant omental cysts from other cystic lesions or ascites, such as mesenteric cysts ( 7 ), intestinal duplication cysts ( 17 , 37 ), and abdominal tubercular ascites ( 8 ). It is necessary to do a chest CT and to detect tumor biomarkers to rule out other rare conditions, especially in patients with stable hemodynamic status ( 44 , 45 ); however, increasing concern regarding radiation exposure and other potential risks from CT scan in babies should be considered ( 46 , 47 ).…”