Neuroblastoma: A Roentgenologic and Pathologic Study

Abstract

A review of the course and therapy of 28 cases of neuroblastoma has been presented, with a twoyear survival of 50% recorded in 26 patients. The treatment of choice is complete surgical removal of the tumor followed by radiation therapy to the tumor bed. Radiation therapy is useful for the treatment of metastatic disease. Our data seem to indicate that the site of origin of the tumor may be the most important prognostic factor. In this series, only 1 patient out of 10 is surviving whose primary tumor was in the adrenal gland, while all patients with extra-adrenal primary sites have survived. In addition, the presence of metastases and the histologic characteristics of the tumor are of prognostic importance. Two cases with metastatic disease and long-term survival are presented.

Case Details

Clinical Characteristics

Abdominal or thoracic paravertebral masses with evidence of calcification; bilateral symmetry of skeletal lesions where skeletal metastases exist; a predominance of mixed destructive and proliferative bone changes; frequent cortical destruction; occasional extension into adjacent soft tissues; the presence of a pathological fracture

Remission Characteristics

The reported tendency of the tumor in some cases to regress spontaneously and to undergo transformation into benign ganglioneuroma

Treatment & Mechanisms

Proposed Remission Mechanisms

Not discussed

Additional Notes

The clinical records and pathologic material were reviewed on 32 histologically proved cases of neuroblastoma seen at the Mayo Clinic in the ten-year period through 1954. The roentgenograms of these patients were carefully studied in an attempt to establish criteria for the roentgenologic diagnosis of this disease. In many instances the diagnosis can be made by the roentgenologist with a high degree of accuracy.