Neuroblastoma is difficult to diagnose through initial symptoms as these are not exclusive to neuroblastoma. Symptoms include irritability, fever and loss of appetite. Neuroblastoma can be diagnosed in the fetal stage during the ultrasound.
What Are The First Symptoms Of Neuroblastoma?
The symptoms of neuroblastoma depend upon the severity of the condition and the organ to which cancer has metastasized. Further, in most cases, the condition is not diagnosed until cancer spread to such an extent that the symptoms start appearing. First symptoms are nor exclusive to neuroblastoma and are overlapping the symptoms of another disease that are common in childhood1. Initial symptoms include loss of appetite, irritability, fever, and frequent crying. Following are the symptoms of neuroblastoma:
- If the neuroblastoma is present in the chest, patient experiences chest pain, drooping eyelids and wheezing4.
- If the neuroblastoma initiates from the abdomen, symptoms include abdominal pain and diarrhea or constipation.
- Bone pain
- Pale skin
- Unexplained weight loss
- Difficulty walking
- Weakness and numbness
- Horner’s syndrome when the nerve of the neck gets damaged and patient experiences sweating, red skin and drooping eyelids.
- Painless lump with bluish tint seen under the skin
- Changes in urination if the tumor affects the urinary system
- Altered cardiovascular parameters such as heart rate and blood pressure.
Testing For Initial Symptoms Of Neuroblastoma
Initial symptoms of neuroblastoma are completely vague and no parent with those initial symptoms may think of his child suffering from neuroblastoma. This is because the symptoms are similar to various other diseases the child suffers commonly in childhood. In rare instances, neuroblastoma is diagnosed in the fetal stage through ultrasound, which is done to examine the birth defects or to check the age of fetus5. Further, the diagnose is done, specifically for those symptoms, when the severity of condition increases and the symptoms experienced are a level up than symptoms for normal diseases. Following are the diagnostic methods for neuroblastoma:
Physical Exam: Doctor will examine the child behavior and evaluate the body for any tumor or abnormal growth.
Blood And Urine Tests: Generally, the neuroblastoma cells secrete catecholamines that are measured through blood or urine tests. Other tests include kidney function test, blood cell count, and electrolytes concentration.
Imaging Techniques: Imaging techniques such as MTR, CT scan, and ultrasound are performed to evaluate the extent of spread of cancer.
Biopsy: Biopsy of the tumor is done to obtain the conclusive evidence for the presence of cancer.
Functional nerve cells originate from immature cells called neuroblasts. However, in some infants, these immature nerve cells do not differentiate into nerve cells rather they form a tumor by abnormal division and growth. This condition of developing the immature neuroblasts to cancer cells is known as neuroblastoma1. In some patients, the condition occurs even before birth but the condition remains undiagnosed until the symptoms began to appear. It is to be noted that although rare, neuroblastoma is one of the most common cancer in infants.
In about two percent of patients, the cause of this condition is genetic while the remaining patients do not inherit neuroblastoma. The condition, in most cases, starts from the adrenal gland tissues. The adrenal gland is present right over the kidneys and is responsible for controller cardiovascular parameters such as heart rate and blood pressure. Neuroblastoma has the potential to metastasize and may spread to bones, liver or skin.
Adults rarely suffer from neuroblastoma. Less than 10% of neuroblastoma cases occur in patients with the age older than 10 years2. Neuroblastoma has a different fate in different patients. In some cases, especially in very young children, cancer cells die and the tumor disappears without any treatment. The reason for this remains unknown. In some of the patients, neuroblastoma may convert to being neuroganglionoma3.
Symptoms of neuroblastoma include abdominal pain, soreness, difficulty breathing, and altered kidney function. Diagnostic techniques include physical evaluation, biopsy, imaging techniques, and blood and urine tests.
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