What Is Neuroblastoma?

Neuroblastoma is a type of cancer that makes up about 15% of pediatric cancers. It is most often diagnosed in children between the ages of 1 and 2 years old, and most cases are diagnosed before age 5.

Neuroblastoma is one of the most common types of cancer affecting the sympathetic nervous system. The tumors develop in immature nerve cells in the adrenal glands (around the kidneys), neck, chest, or spinal cord.

This article covers the types, symptoms, causes, diagnosis, and treatment of neuroblastomas.

Types of Neuroblastomas

Neuroblastomas can develop anywhere within the sympathetic nervous system. Most of the time, a tumor develops on the adrenal glands, which sit on top of the kidneys. However, the tumors can form anywhere that there are immature sympathetic nerve cells.

Places where neuroblastomas may develop include:

• Adrenal glands
• Chest
• Neck
• Spine
• Abdomen
• Pelvis

Neuroblastoma Symptoms

Signs of neuroblastoma vary based on where in the body the tumor is located, as well as the stage of the illness. With mild forms of neuroblastoma, the only noticeable sign might be feeling a lump on your child’s neck, abdomen, or back. If the tumors spread to other parts of the body, it tends to cause more severe illness.

Symptoms of neuroblastoma include:

• Abdominal, chest, or pelvic pain
• A mass or lumps of tissue under the skin
• Diarrhea or constipation
• Shortness of breath or wheezing
• Changes to eyes (e.g., drooping eyelids, unequal pupil size, bulging eyes)
• Dark circles around the eyes
• Back pain
• Fever
• Unexplained weight loss
• Fatigue
• Bone and joint pain
• Weakness or trouble moving a body part
• Easily bruising or bleeding

Causes

Nerve cells and the cells in the adrenal glands all begin as a type of cell called neuroblasts, which are immature nerve cells that normally grow into mature cells. Sometimes, the neuroblasts remain undeveloped and continue to multiply. When this happens, a neuroblastoma forms.

The immature nerve cells usually mature or die off. Even when a neuroblastoma forms, it will often go away on its own. However, neuroblastomas sometimes continue to grow and become malignant cancer.

Genetics

In general, cancer is caused by a genetic mutation that makes cells keep multiplying and disables normal cell growth. Genes can be inherited, and having a family history of neuroblastoma means a child is at higher risk for the disease.

Genes sometimes mutate spontaneously for reasons that are not fully understood. When this happens, a child develops neuroblastoma even though no one else in their family has the disease.

A few known genes that affect neuroblastoma include:

• MYCN
• ALK
• PHOX2B

Diagnosis

Several tests and procedures are used to diagnose and stage neuroblastomas, including:

• Physical exam: Your child’s healthcare provider will conduct a physical exam to assess their physical signs and symptoms.
• Medical history: Your child’s provider will ask you questions about your child’s symptoms, habits, behaviors, history of illness or surgeries, as well as your family medical history.
• Imaging: X-rays, ultrasounds, CT scans, MRIs, and other imaging tests can be ordered to look for and assess the potential mass in your child’s body.
• Biopsy: A sample of tissue from the mass, bone marrow, or other body tissue can be collected to look at more closely for signs of cancer. This information is also useful for developing an effective treatment plan.

Once your child is diagnosed with neuroblastoma, their provider may recommend further testing to determine the stage of the tumor (severity). They will also want to determine whether cancer has spread to other parts of the body (malignancy).

Treatment

The recommended treatment for neuroblastoma depends on the stage of cancer, malignancy (spread to other areas of the body), your child’s age, and other health considerations.

Your child’s provider will discuss your treatment options. If the tumor is found early, a provider might simply observe the neuroblastoma to see if it goes away on its own.

The older the child is, the less likely it is that neuroblastomas will resolve on their own. In this case, treatment can include surgery, radiation, chemotherapy, or a combination of these treatments.

Surgery

If the cancer is only in one location, it might be possible to completely remove the tumor. In this case, your child might not require other types of treatment.

During the surgery, a surgeon uses tools to physically remove cancer cells from the body. The location and size of the tumor will influence whether a surgeon will be able to remove all of the cancer cells.

For example, it might be too risky to completely remove tumors that are located around vital organs, such as the spinal cord or lungs.

Radiation

Radiation therapy uses high-energy beams (such as X-rays) to kill cancer cells. Usually, radiation therapy is completed through external-beam radiation therapy, where a machine is used outside the body to aim a radiation beam at the cancer cells.

Chemotherapy

Chemotherapy involves medications that travel throughout the body to kill rapidly dividing cancer cells. The medications can be taken by mouth or injected into a vein or muscle.

When to See a Healthcare Provider

If you notice any lumps, symptoms, or changes in your child’s behavior, bring these concerns to their doctor. In many cases, the symptoms will likely not be a cause for concern.

However, it if turns out that your child’s symptoms are related to neuroblastoma, early diagnosis can help prevent the condition from becoming severe and may mean that your child needs less treatment.

Coping

It’s common to feel a range of emotions—shock, devastation, disbelief, and worry—as you make decisions about your child’s treatment. It can be overwhelming to try to care for your family, and you might find it difficult to care for yourself during this time.

It’s important that you reach out for support, which may include:

• Find support groups for neuroblastoma: You might consider connecting with other families going through cancer diagnosis and treatment. You can find groups online, through cancer organizations, or ask your child’s healthcare team for recommendations.
• Talk with family and friends: You can lean on the people in your life for emotional support as well as to help with practical matters, such as watching your other children while you take your child to a doctor’s appointment.
• Therapy: Processing the shock and stress of a child going through cancer treatment is challenging. A mental health professional can help you learn to cope with the stress and process your emotions.
• Cancer resources: It’s also important to find ways to help your child cope with their diagnosis. For example, your child might be eligible for summer camps or other programs that are designed for children with cancer and other life-threatening illnesses.

A Word From Verywell

If your child has been diagnosed with neuroblastoma or you are concerned about any symptoms that they are having, talk to their doctor. They can assess your child, and if they diagnose them with neuroblastoma, they can guide you through making decisions about treatment.