Abstract. Renal neuroblastoma is uncommon, particularly in adults, with only a few cases having been reported in studies published in the English language. The incidence is only 0.12 cases/1 million individuals in those aged >20 years. Studies of the pathogenesis, biological characteristics, treatment and prognosis of renal neuroblastoma are limited due to this low incidence. The present study reports the case of a 22-year-old adult female who was diagnosed with a left renal neuroblastoma by computed tomography (CT), bone scan and pathological examination. The patient underwent a left nephroureterectomy, ipsilateral lymph node dissection and post-operative radiotherapy, prior to discharge 60 days after admittance. At the nine-month follow-up examination, the patient showed no evidence of recurrence, progression or metastatic disease on the CT scans of the chest, abdomen and pelvis. Renal neuroblastoma is extremely uncommon in adults. The diagnosis and treatment of renal neuroblastoma is complicated by the overall low incidence, lack of specific treatment guidelines, advanced disease state due to late presentation, and its associated co-morbidities. Further study of the pathogenesis, biological and clinical characteristics, and treatment of renal neuroblastoma is required to provide an optimal treatment for patients and to improve the patient's quality of life.
IntroductionNeuroblastoma is the most common extracranial solid tumor to occur during childhood. The cancer arises in the sympathetic nervous system and mainly affects the adrenal glands and retroperitoneum, with a distribution pattern that is similar in children and adults. In total, >90% of the tumors are diagnosed in children <10 years old (1). The incidence in those >20 years old has been reported to be only 0.12 cases/1 million individuals (2). Renal neuroblastomas are extremely uncommon, particularly in adults. To the best of our knowledge, to date only one case of adult intrarenal neuroblastoma has been reported in the literature (3). The number of studies on the pathogenesis, biological characteristics, treatment and prognosis of the cancer have been limited due to this low incidence. The present study reports a case of left renal neuroblastoma in an adult patient with multiple bone and joint metastases, and discusses its clinical manifestations, diagnosis and treatment. Written informed consent was obtained from the patient's family.
Case reportIn December 2013, a 22-year-old female was admitted to the Affiliated Hospital of Guangdong Medical College (Zhanjiang, China)with abdominal and joint pain that had been present for >10 days. There was no significant medical history. The patient had experienced no fever, chills, diarrhea, nausea, vomiting or hematuria. A physical examination revealed that the abduction, internal rotation and extension of the left shoulder and hip were limited. Computed tomography (CT) of the abdomen and pelvis showed a large heterogeneous and centrally necrotic mass, measuring 8.2x7.3x3.1 cm, in the upper pole of the left k...