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Management Of Cervicomediastinal Neuroblastoma Presenting With Life-threatening Tracheal Obstruction In Infancy.

Komuro & Hoshino, 2013Neuroblastoma

Komuro, H., & Hoshino, N. (2013). Management of cervicomediastinal neuroblastoma presenting with life-threatening tracheal obstruction in infancy. Journal of pediatric hematology/oncology, 35(8), e323–e325. https://doi.org/10.1097/MPH.0b013e31827b4747

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Abstract

The authors report on 3 infants below 6 months of age at diagnosis, with cervicomediastinal neuroblastoma who presented with life-threatening tracheal obstruction as an oncologic emergency. These neuroblastomas were characterized by favorable biology and chemoresistance. All initially grew rapidly before spontaneously regressing. Nerve injuries occurred in all patients as a result of tumor location. Maintenance of the airway until the expected spontaneous regression was a critical component in the management of these patients.

Case Details

Disease Location

Right side cervicomediastinal tumor

Personal Characteristics

Newborn

Clinical Characteristics

Diagnosed at birth, intubated, CT showed mass compressing airways and emergent subtotal resection done at 2 days of age -> histology showed favorable features according to shimada classification - hyperdiploidy, no myc-n, low mki. Chemo started 4 weeks post -> aggressive growth of tumor and increased u. Vma, hva. Pod66: again intubated because of tracheal occlusion, developed ischemic brain injury. At 6 months, tumor sarted regressing witho any chemo. Compete regression at 2years. .

Remission Characteristics

Chemo started 4 weeks post -> aggressive growth of tumor and increased u. Vma, hva. Pod66: again intubated because of tracheal occlusion, developed ischemic brain injury. At 6 months, tumor sarted regressing witho any chemo. Compete regression at 2years.

Treatment & Mechanisms

Clinical Treatment

Chemotherapy