Neuroblastoma in children, stage 4. Causes, signs, symptoms, prognosis. Neuroblastoma treatment in a child

Neuroblastoma is a cancer of the sympathetic nervous system. In most cases, this ailment is detected in young children. Timely detection of it can increase the chances of a final recovery. From the materials of this article you will learn the main causes of the origin of pathology, what signs it accompanies, when treatment is required.

The amazing nature of neuroblastoma in a child

Neuroblastoma is the most common malignant tumor . It accounts for about 15% of all recorded cases of neonatal neoplasm, as well as early childhood. Specialists usually detect a tumor in children under five, but there are cases of illness in adolescents 11 and even 15 years. As the child grows and develops, the probability of encountering this insidious disease decreases every year.

A tumor of neuroblasts, according to doctors, is endowed with amazing abilities. It is particularly aggressive and prone to metastasis in any part of the body. Most often, bone and lymphatic systems suffer from her life. Sometimes doctors fix the growth of the foci of neuroblasts, their division with the subsequent formation of a tumor. It first gives metastases, and then suspends its development and begins to regress. Malignant formations of a different type are not characterized by such manifestations.

Neuroblastoma of the brain in children was first studied by a scientist from Germany, Rudolf Virchow in 1865. The doctor called the tumor "glioma". A few decades later, the American scientist James Wright explored the neoplasm in more detail and explained in detail the process of its formation.

Development of neuroblastoma by stages

Like any other cancer neoplasms, neuroblastoma in children undergoes several conditional stages of development, the definition of which allows you to assign effective treatment:

• Stage 1. It is characterized by the presence of an operable tumor, the size of which does not exceed 5 cm, and the absence of metastases in the lymph nodes.
• Step 2A. Witnesses a localized tumor, most of which is to be removed.
• Stage 2B. There is a metastatic lesion of lymph nodes unilaterally.
• Stage 3. It is characterized by the appearance of a bilateral tumor.
• Step 4 (A-B). Neoplasm increases, metastasis is observed in the bone marrow, liver and lymph nodes.

Separately, we should consider how neuroblastoma develops in children at the last stage. Stage 4 is not characterized by other biological characteristics of the remaining neoplasia, has a good prognosis, and with timely treatment gives a high survival rate.

The main causes of tumor development

Neuroblastoma, like other types of oncology, develops against the background of genetic mutations in the body. At present, specialists can not say what exactly gives impetus to these changes. It is assumed that a certain role is played by the so-called carcinogenic factors, that is, chemicals and irradiation. The cells that arise as a result of mutations begin to multiply rapidly, forming a tumor. Malignant neoplasm is characterized by the ability to divide, which distinguishes it from benign.

The mutation provoking the formation of neuroblastoma, occurs even during fetal development or immediately after the birth of the child. Therefore, most patients are infants. The origin of the tumor begins in neuroblasts. These are immature nerve cells that form in the fetus during its intrauterine development. In the normal course of pregnancy, neuroblasts take on the functions of nerve fibers or become cells responsible for the formation of the adrenal glands.

By the time the child's birth, most of them have already been formed. Immature cells usually disappear. In the pathological course of this process, the neuroblasts are transformed into a tumor. The only confirmed factor of cancer occurrence is a genetic predisposition. However, the risk of hereditary development of the disease does not exceed 2%.

Most often, doctors diagnose retroperitoneal neuroblastoma, the favorite area of localization of which is the adrenal gland. Theoretically, the tumor can occur in any part of the body. Neuroblastoma of the retroperitoneal space in children occurs in 50% of cases, in 30% of the patients the neoplasm develops from the nerve lumps of the lumbar region, while the remaining 20% chooses the cervical and thoracic areas for localization.

How does the tumor manifest?

At the initial stage of the appearance of the pathological process, no specific symptoms are observed. Therefore, the tumor is often perceived for other diseases characteristic of this age.

The signs of neuroblastoma in children are manifested depending on the site of localization of the neoplasm, the areas of metastasis and the level of vasoactive substances. Usually the primary tumor site is in the retroperitoneal space, more precisely in the adrenal gland. In rare cases, it is located on the neck or in the mediastinum.

How is neuroblastoma manifested in children? Symptoms of the disease are caused by the release of hormones by cancer cells or the constant pressure of the tumor on one or another organ. Sometimes its growth affects the functioning of the intestine and bladder. Because of the squeezing of the blood vessels in patients there is swelling of the scrotum and lower limbs.

Reddish or bluish spots on the skin are also signs of neuroblastoma in a child. Their appearance signals the involvement of epidermal cells in the pathological process. When a tumor penetrates directly into the bone marrow, the baby becomes weak, often sick. In this case, even a small wound can lead to extensive bleeding.

Noticing the symptoms of neuroblastoma, parents should consult a doctor. Early detection of cancer can save a child's life.

Neuroblastoma of retroperitoneal space

Neoformation from tissues of neurogenic origin, arising in the retroperitoneal space, is characterized by rapid growth. Within a short period of time, it penetrates into the spinal canal, forming a solid in consistence tumor, which can be detected by palpation.

Neuroblastoma of the adrenal gland in children initially does not have specific symptoms until it reaches an impressive size and does not begin to attach adjacent tissues. What are the signs of a tumor?

1. Presence of dense education in the abdominal cavity.
2. Puffiness of the whole body.
3. Discomfort and soreness in the lower back.
4. Decreased body weight.
5. Temperature increase.
6. Change in blood indicators that indicate anemia.
7. Numbness, paralysis of the lower extremities.
8. Disorder of functional abilities of the digestive tract and excretory system.

Other localizations of tumors of neurogenic origin

Neuroblastoma of the posterior mediastinum in children is accompanied by a sharp weight loss, difficulty swallowing, a disorder of respiratory activity. In some cases, the ailment leads to a change in the shape of the chest.

Tumors of the occipital space are extremely rare, but they are more known about them. This is due to the fact that all signs of the pathological process are visible to the naked eye. Neoplasm is characterized by the appearance of a dark patch on the eye that resembles an ordinary bruise. Another symptom of neuroblastoma is the drooping eyelid. It covers the unnaturally bulging eyeball.

Forms of neuroblastoma

Currently, experts identify four forms of neuroblastoma, each of which has a specific location and distinctive characteristics.

• Medulloblastoma. Neoplasm is born deep in the cerebellum, because of what its removal is impossible through surgical intervention. Pathology is characterized by rapid metastasis. The very first symptoms of the tumor are manifested in a violation of coordination of movements.
• Retinoblastoma. It is a malignant tumor that affects the retina of the eyes in small patients. Absence of treatment leads to total blindness and metastasis in the brain.
• Neurofibrosarcoma. This tumor is located in the abdominal cavity.
• Sympatoblastoma. It is a tumor of malignant nature, which selects the sympathetic nervous system and adrenal glands by its "home". Neoplasm is formed in the fetus during its intrauterine development. Because of the rapid increase in the size of sympathoblastoma, the spinal cord can be affected, which entails paralysis of the limbs.

How to recognize neuroblastoma?

Initially, the doctor prescribes a blood and urine test when a diagnosis of "neuroblastoma" is suspected. In children, the symptoms of this pathology are similar to other diseases, and a laboratory study of biological materials makes it possible to exclude other possible causes. High rates of catecholamine hormones in the urine indicate the presence of oncology.

To determine the size of the tumor and its location, small patients are prescribed CT, ultrasound and MRI. An important method of diagnosis is biopsy. During this procedure, a specialist makes a selection of cancer cells for their subsequent study in the laboratory, conducting a histological analysis.

Based on the results of the analysis, the doctor develops treatment tactics, gives recommendations on the regimen and lifestyle of the patient.

Treatment options

Treatment of neuroblastoma in a child usually involves several specialists oncology department (chemotherapist, surgeon, radiologist). After studying the characteristics of the tumor, doctors develop tactics for its destruction. It depends on how the neoplasm responds to ongoing activities, and from the prognosis at the time of the establishment of the final diagnosis.

Usually treatment of neuroblastoma in children includes the following methods:

1. Chemotherapy. This procedure involves the introduction of antitumor drugs according to specially designed schemes. Drugs are destructive to cancer cells, preventing their reproduction. Together with them other parts of the body suffer, which leads to common side effects (hair loss, nausea, diarrhea). The effectiveness of the therapy is increased several times in combination with brain transplantation.
2. Surgical treatment involves the removal of tumors. Before the operation, chemotherapy is used. It can slow the growth of the tumor and lead to a regression of metastases. The permissibility of its complete removal depends on the location and size. A small neoplasm located near the spinal cord makes the intervention very risky.
3. Radiation therapy in modern medical practice is extremely rare. It is increasingly replaced in recent times by surgery, since exposure is unsafe and carries a certain threat to the life of the child. Radiation therapy is recommended strictly according to indications, when there is a low efficiency of other methods of treatment, in the case of inoperable neuroblastoma in a child.

A special diet for such a diagnosis is not prescribed for small patients. Many parents, trying to fight in all possible ways for the life of a child, adjust his diet. It is proved that some products, more precisely, the substances contained in them, increase the body's defenses and significantly slow the growth of the tumor. These substances include zinc, iron, betaine, various vitamins. They are rich in citrus fruits, young greens, carrots, pumpkins.

The success of any therapy depends on the size of neuroblastoma in children. The causes of the pathology and stage of the disease also have significance. The use of radical methods at the initial stages of tumor formation gives hope for a complete recovery. However, this does not relieve a small patient from visiting the doctor and undergoing a survey in order to prevent a possible relapse.

The likelihood of a final recovery is not excluded in the second stage, provided a successful operation and chemotherapy.

Certain difficulties arise at the last stages of the development of such a pathology as neuroblastoma. In children, stage 4 cancer is usually accompanied by disappointing predictions. Relapse is possible after removal of the tumor, against the backdrop of a seeming recovery. The next formation of malignant nature is usually formed in the same place as before. The prognosis at this stage is 20% survival for five years. In this case, everything depends on the skills of specialists, the availability of necessary medical equipment.

Forecast

After intensive oncology therapy, the prognosis in most patients is favorable. In children with a localized tumor process, doctors note a high probability of recovering in the shortest possible time. With regard to this category of patients, neoplasm can disappear even without surgical intervention, but intensive medication in this case is mandatory. In older children with a spreading tumor, the chances of a final recovery are much lower. Moreover, the neoplasm may reappear.

The consequence of treatment is often secondary neuroblastoma in children. The forecast in this case is not the most favorable. A tumor can appear several years later, including after a successful treatment. Such consequences in medicine are called a belated side effect. That is why all patients without exception after the course of therapy are recommended to be observed at doctors constantly.

Preventive actions

Doctors do not give any specific recommendations to prevent the development of a malignant tumor, since the reasons for its formation remain poorly understood, with the exception of the alleged hereditary predisposition. If close relatives have ever had to deal with this insidious diagnosis, it is advisable to visit a doctor of genetics during pregnancy planning. Probably, it will help in the future to avoid the unrest associated with the birth of an unhealthy child.

Unfortunately, oncological diseases are increasingly diagnosed in young patients, is not an exception to neuroblastoma in children. Photo pathology can be seen in specialized medical reference books. Specific methods of prevention doctors can not offer because of the unclear etiology of pathology. When there are primary symptoms indicative of this ailment, it is extremely important to seek medical help from a doctor. Only after passing a full diagnostic examination can we judge the nature of the neoplasm and develop an approximate treatment tactic. The earlier a specialist confirms the final diagnosis, the higher the chances of a full recovery. Be healthy!