Complete Pathologic Maturation and Regression of Stage IVS Neuroblastoma Without Treatment

Case Details

Personal Characteristics

3.6 kilogram infant boy born in 1979 after a full-term pregnancy with normal labor and delivery

Clinical Characteristics

Many subcutaneous nodules, palpable abdominal mass, leukocyte count of 12,000 cells/microliter, platelet count of 390,000 cells/microliter, neoplastic cells in bone-marrow aspirate, left calcified suprarenal mass 5 centimeters in diameter, multiple subcutaneous areas of uptake, malignant, densely cellular, poorly differentiated neoplasm, large nuclei, ill-defined borders, prominent mitotic activity, markedly elevated vanillylmandelic acid (vma) of 240 micrograms/mg of creatinine

Remission Characteristics

Spontaneous maturation and involution over a 6-year period, decrease in size of subcutaneous nodules, vma decreased to normal, no viable tumor in adrenal gland at age 3, no abnormal areas in bone scan at age 6 years, 9 months

Treatment & Mechanisms

Proposed Remission Mechanisms

Spontaneous maturation

Clinical Treatment

No cytotoxic therapy was administered

Non-Clinical Treatment

Blood transfusion, treatment with nafcillin

Additional Notes

Patient was observed closely, but no surgery or chemotherapy was used. Favorable biologic prognostic factors were documented, including tumor DNA and protein analyses for N-myc amplification or overexpression and analysis for serum neuron-specific enolase and ferritin.