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| neuroblastoma | |
|---|---|
| Name | Neuroblastoma |
| Field | Pediatric oncology |
| Onset | Infancy, early childhood |
neuroblastoma
Neuroblastoma is a pediatric solid tumor arising from sympathetic nervous system precursor cells, most commonly presenting in infancy and early childhood. It intersects with pediatric oncology centers such as St. Jude Children's Research Hospital, specialized laboratories at Dana–Farber Cancer Institute, and collaborative groups like the Children's Oncology Group; patients may be cared for in tertiary centers including Great Ormond Street Hospital and Boston Children's Hospital. Management often involves multidisciplinary teams connected to institutions such as Memorial Sloan Kettering Cancer Center, Mayo Clinic, and research consortia including International Society of Paediatric Oncology.
Presentation is variable and can include a palpable abdominal mass, periorbital ecchymoses, and systemic features that prompt referral to centers like Johns Hopkins Hospital, Cleveland Clinic, or regional pediatric units such as Texas Children's Hospital. Symptoms may mimic other pediatric conditions seen at tertiary hospitals like Children's Hospital of Philadelphia and may lead to imaging at centers such as Royal Children's Hospital, Melbourne or SickKids Hospital. Clinical signs such as Horner syndrome, spinal cord compression, or paraneoplastic syndromes often necessitate urgent assessment at institutions including Karolinska University Hospital and Erasmus MC.
Tumorigenesis involves aberrant development of neural crest derivatives and molecular alterations identified by laboratories like Broad Institute, Wellcome Sanger Institute, and research groups at National Institutes of Health. Key genetic features include amplification of the MYCN oncogene, alterations in ALK, and ATRX mutations, findings corroborated in genomic studies published by teams at Cold Spring Harbor Laboratory and Harvard Medical School. Chromosomal abnormalities such as 1p deletion and 11q deletion have been characterized in cohort analyses by centers like Memorial Sloan Kettering Cancer Center and European Genome-phenome Archive. Signaling pathways relevant to transformation have been probed by investigators from Massachusetts Institute of Technology and Stanford University School of Medicine.
Diagnosis relies on biochemical testing (urinary catecholamines) and imaging modalities performed at radiology departments in hospitals such as Mayo Clinic and Houston Methodist Hospital. Cross-sectional imaging with computed tomography or magnetic resonance imaging is frequently obtained at institutions like UCLA Medical Center and interpreted by radiologists affiliated with Johns Hopkins Hospital. Metaiodobenzylguanidine scintigraphy and positron emission tomography may be coordinated through nuclear medicine services at Memorial Sloan Kettering Cancer Center and UCSF Medical Center. Histopathological assessment and immunohistochemistry are undertaken by pathology units at centers including Royal Marsden Hospital and Guy's and St Thomas' NHS Foundation Trust.
Staging systems developed through international collaborations such as the International Neuroblastoma Risk Group and guidelines from the Children's Oncology Group guide risk assignment used worldwide, including in protocols from French Society of Paediatric Oncology and German Society for Paediatric Oncology and Haematology. Risk stratification integrates age, stage, histology, MYCN status, and chromosomal aberrations; these criteria are applied in trials run by groups like COG and European cooperative trials coordinated through SIOPEN.
Treatment paradigms range from observation for select low-risk infants to multimodal therapy for high-risk disease, with surgical resection performed at pediatric surgery centers such as St. Mary's Hospital (London) and oncologic care at Seattle Children's Hospital. Chemotherapy regimens were developed in cooperative trials at Children's Oncology Group and administered at comprehensive cancer centers including MD Anderson Cancer Center. High-dose chemotherapy with autologous stem cell rescue is delivered in transplant programs at places like Fred Hutchinson Cancer Center and University of Minnesota Medical Center, while immunotherapy using anti-GD2 monoclonal antibodies has been advanced by research teams at Memorial Sloan Kettering Cancer Center and biotech collaborators. Radiotherapy, including targeted radionuclide therapy, is provided by radiation oncology services at institutions such as Royal Marsden Hospital and Peter MacCallum Cancer Centre.
Outcomes vary by risk group; long-term survivorship care is coordinated by pediatric oncology survivorship programs at institutions such as St. Jude Children's Research Hospital and Dana–Farber Cancer Institute. Relapse patterns and late effects have been characterized in longitudinal cohorts tracked by registries like the SEER Program and multinational studies involving European Organisation for Research and Treatment of Cancer. Novel therapies and clinical trials at National Cancer Institute, Dana–Farber Cancer Institute, and academic centers influence evolving survival statistics presented by organizations such as World Health Organization and UNICEF in global oncology reports.
Neuroblastoma incidence, age distribution, and geographic variation are reported in cancer registries including the Surveillance, Epidemiology, and End Results Program, European Cancer Information System, and national databases from agencies such as the UK Office for National Statistics and Australian Institute of Health and Welfare. Preventive strategies remain limited; public health surveillance and research funding are overseen by bodies like the National Institutes of Health, European Commission, and philanthropic organizations such as the Leukemia & Lymphoma Society and Alex's Lemonade Stand Foundation.
Category:Pediatric cancers