Prenatal Diagnosis and Subsequent Treatment of an Intermediate-Risk Paraspinal Neuroblastoma: Case Report and Review of the Literature

Abstract

Objectives: Neuroblastoma is the most common extracranial solid tumor of childhood, and the most common malignancy diagnosed during infancy. In comparison, neonatal neuroblastoma is relatively rare. Improvements in prenatal imaging and widespread use of fetal ultrasonography have led to an increased rate of prenatal diagnoses. Methods: Case report and literature review. Results: We report a case of an intermediate-risk neuroblastoma, diagnosed at 36 weeks’ gestation by ultrasound and subsequently visualized by fetal MRI, that resulted in spinal cord compression and decreased fetal movement. A multidisciplinary team approach resulted in rapid delivery, evaluation, biopsy, staging, and treatment implementation in a successful effort to preserve lower extremity function. Conclusion: Prenatal diagnosis of neuroblastoma, management and outcomes are reviewed. Prompt diagnosis can strongly influence perinatal management and improve prognosis.

Neuroblastoma presenting with symptoms of epidural compression at birth: a case report

“…These young patients have a high survival probability, but almost all develop severe sequelae [ 4 , 5 ]. The discovery of a neuroblastoma associated with EC at birth is a rare event [ 6 ], as witnessed by the fact that only 0.2 % of all diagnoses of this tumour were registered by the Italian Association of Hematology and Oncology (AIEOP) Neuroblastoma Registry over a period of 10 years [ 7 ]. The literature concerning these patients is limited to a small number of mostly single-case reports [ 6 , 8 – 16 ].…”

“…The discovery of a neuroblastoma associated with EC at birth is a rare event [ 6 ], as witnessed by the fact that only 0.2 % of all diagnoses of this tumour were registered by the Italian Association of Hematology and Oncology (AIEOP) Neuroblastoma Registry over a period of 10 years [ 7 ]. The literature concerning these patients is limited to a small number of mostly single-case reports [ 6 , 8 – 16 ]. We describe herewith a newborn whose delivery was anticipated to the 36 th week of pregnancy for olygohydramnios and was found to have motor deficit and bladder dysfunction at birth secondary to an abdominal neuroblastoma.…”

Prenatal Detection of an Extra‐Adrenal Neuroblastoma With Hepatic Metastases

“…Fetal detection is even rarer, and the paucity of reports in the literature attests to this (Table 1). [1][2][3][4][5][6][7][8] We report a case in which sonography and magnetic resonance imaging (MRI) were used in the detection and evaluation of an extra-adrenal metastatic neuroblastoma in a fetus.…”

“…A C Because of its low incidence, few cases of extraadrenal neuroblastomas have been detected prenatally. [1][2][3][4][5][6][7][8]14 Fénart et al 15 and Sones 16 first reported the prenatal sonographic diagnosis of an adrenal neuroblastoma. Gadwood and Reynes 2 first reported a prenatally diagnosed case of an extra-adrenal neuroblastoma located in the neck of a fetus.…”

“…It can show extension of the mass into the neural foramina. 5,6 The main advantage of MRI over computed tomography is its ability to image in any plane (Figure 1). T2-weighted MRI is likely to provide a better differential diagnosis of a neuroblastoma from conditions such as adrenal hemorrhage and is thus an important adjunct to sonography, especially in cases in which sonographic findings are unclear because of maternal obesity.…”