User:LittleMisterLittle/Neuroblastoma

Neuroblastoma is a specified and targeted type of cancer that starts in certain types of primitive developing nerve cells found in an embryo or fetus. The term "neuroblastoma" may be broken down into "neuro," indicating nerves, and "blastoma," referring to a cancer that affects immature or developing cells (precursor cells), often called blasts. Because neuroblastoma is a "targeted cancer," it affects a limited age range, most commonly occurring in infants and young children and rarely found in children older than 10 years.

Development & Behavior
Neuroblastomas start in early nerve cells of the sympathetic nervous system and can be found anywhere along this system. There are three most common areas : In rare cases, a neuroblastoma may spread so widely by time of discovery that doctors cannot tell exactly where it started. Also rare, neuroblastoma may be found before birth by fetal ultrasound. In very young infants, cells often die without any cause and the tumor may disappear or the cells may mature spontaneously into normal ganglion cells and stop dividing. These normal ganglion cells create a benign tumor called ganglioneuroma which is formed of mature ganglion and nerve sheaths that do not continue to grow, thus being non-malignant. These ganglioneuromas may be removed by surgery and may be examined under a microscope to determine if further treatment is needed.
 * Adrenal glands: 1/3 of neuroblastomas will start in the adrenal glands located on the top of each kidney in the back of the upper abdomen.
 * Sympathetic nerve clusters:
 * 1/3 start in the sympathetic nerve clusters of the abdomen.
 * 1/3 start in the sympathetic nerves of the chest or neck or in the pelvis.

Signs & Symptoms
The signs and symptoms of neuroblastoma may vary depending on the location and size of the original tumor Typical signs and symptoms include: About two out of three cases of neuroblastoma have spread to other parts of the body by diagnosis. Neuroblastoma frequently spreads to bones causing a child to refuse to walk.
 * lump in the abdomen, neck, or chest
 * bulging eyes that include dark circles
 * bone pain
 * swollen stomach and trouble breathing in infants
 * painless, bluish lumps under the skin in infants
 * weakness or paralysis (loss of ability to move a body part)

Diagnosis
Diagnosis may be achieved with a physical exam and history to check general signs of health, including checking for signs of disease, such as lumps or anything else that seems unusual, and a history of the patient’s health habits and past illnesses and treatments; a twenty-four-hour urine test; blood test; bone marrow biopsy; standard biopsy with removal of cells or tissues so they may be viewed under a microscope by a pathologist to check for signs of cancer; X-ray or CT scan; or an ultrasound exam. Age of the patient along with stage and location of the cancer play a major role in the prognosis and treatment decisions. The stages of neuroblastoma are broken down into four specific classifications; stage I, stage II a, stage II b, stage III, stage IV and stage IV S. Prognostic markers help classify these stages and help predict the child's possiblility of cure. Age, tumor histology, DNA ploidy, cytogenetics and serum markers may be used.

Treatment
Treatments depend on the specific stage or risk group. Surgery is the most common treatment for neuroblastoma. Depending on where the tumor is and whether it has spread, as much of the tumor as possible will be removed. If difficulties arise in removing the tumor, a biopsy may be performed instead. Radiation therapy treats the cancer with high-energy x-rays or other types of radiation to kill cancer cells or keep them from growing. The two types of radiation therapy used are external and internal radiation therapy: external therapy uses a machine outside the body to send radiation toward the cancer; internal therapy uses a radioactive substance sealed in needles that are placed directly into or near the cancer. Chemotherapy treatment uses drugs to stop the growth of cancer cells by killing the cancer cells or stopping cell division. Regional chemotherapy is used for the targeted areas of cancer. In this chemotherapy, the drugs are placed directly into the spinal column, an organ, or a body cavity such as the abdomen; the drugs mainly affect cancer cells in those areas.