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Neuroblastoma
Andrew T. Trout, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Pathology

        • Clinical Issues

          • Diagnostic Checklist

            TERMINOLOGY

            • Definitions

              • Embryonic tumor derived from primitive neural crest cells along peripheral sympathetic chain
                • Primary tumor
                  • Along sympathetic chain
                    • ~ 30% adrenal medulla
                    • ~ 60% abdominal paraspinal ganglia
                  • Tends to infiltrate and surround; extends into neural foramina, encases vessels
                  • Variable calcification, tends to further calcify with therapy
                • Metastases
                  • Bone, lymph nodes, liver, lung, brain, soft tissue

            IMAGING

            • F-18 FDG PET/CT Findings

              • F-18 F-DOPA PET/CT Findings

                • I-124 MIBG PET/CT Findings

                  • Nuclear Medicine Findings

                    • Other Modality Findings

                      DIFFERENTIAL DIAGNOSIS

                        PATHOLOGY

                        • General Features

                          • Staging, Grading, & Classification

                            • Gross Pathologic & Surgical Features

                              • Microscopic Features

                                CLINICAL ISSUES

                                • Presentation

                                  • Demographics

                                    • Natural History & Prognosis

                                      • Treatment

                                        DIAGNOSTIC CHECKLIST

                                        • Consider

                                          Selected References

                                          1. Liu YL et al: Diagnostic FDG and FDOPA positron emission tomography scans distinguish the genomic type and treatment outcome of neuroblastoma. Oncotarget. 7(14):18774-86, 2016
                                          2. Bleeker G et al: 123I-MIBG scintigraphy and 18F-FDG-PET imaging for diagnosing neuroblastoma. Cochrane Database Syst Rev. CD009263, 2015
                                          3. Lee JW et al: Prognostic value of pretreatment FDG PET in pediatric neuroblastoma. Eur J Radiol. 84(12):2633-9, 2015
                                          4. Gil TY et al: Clinical experience with (18)F-fluorodeoxyglucose positron emission tomography and (123)I-metaiodobenzylguanine scintigraphy in pediatric neuroblastoma: complementary roles in follow-up of patients. Korean J Pediatr. 57(6):278-86, 2014
                                          5. Louis CU et al: Neuroblastoma: Molecular Pathogenesis and Therapy. Annu Rev Med. ePub, 2014
                                          6. Lu MY et al: Characterization of neuroblastic tumors using 18F-FDOPA PET. J Nucl Med. 54(1):42-9, 2013
                                          7. Mueller WP et al: Nuclear medicine and multimodality imaging of pediatric neuroblastoma. Pediatr Radiol. 43(4):418-27, 2013
                                          8. Davidoff AM: Neuroblastoma. Semin Pediatr Surg. 21(1):2-14, 2012
                                          9. Piccardo A et al: Comparison of 18F-dopa PET/CT and 123I-MIBG scintigraphy in stage 3 and 4 neuroblastoma: a pilot study. Eur J Nucl Med Mol Imaging. 39(1):57-71, 2012
                                          10. Colon NC et al: Neuroblastoma. Adv Pediatr. 58(1):297-311, 2011
                                          11. Cohn SL et al: The International Neuroblastoma Risk Group (INRG) classification system: an INRG Task Force report. J Clin Oncol. 27(2):289-97, 2009
                                          12. Monclair T et al: The International Neuroblastoma Risk Group (INRG) staging system: an INRG Task Force report. J Clin Oncol. 27(2):298-303, 2009
                                          13. Sharp SE et al: 123I-MIBG scintigraphy and 18F-FDG PET in neuroblastoma. J Nucl Med. 50(8):1237-43, 2009
                                          14. Taggart DR et al: Comparison of iodine-123 metaiodobenzylguanidine (MIBG) scan and [18F]fluorodeoxyglucose positron emission tomography to evaluate response after iodine-131 MIBG therapy for relapsed neuroblastoma. J Clin Oncol. 27(32):5343-9, 2009
                                          15. Ilias I et al: New functional imaging modalities for chromaffin tumors, neuroblastomas and ganglioneuromas. Trends Endocrinol Metab. 16(2):66-72, 2005
                                          16. Juweid ME et al: 111In-pentetreotide versus bone scintigraphy in the detection of bony metastases of neuroblastoma. Nucl Med Commun. 23(10):983-9, 2002
                                          17. Lonergan GJ et al: Neuroblastoma, ganglioneuroblastoma, and ganglioneuroma: radiologic-pathologic correlation. Radiographics. 22(4):911-34, 2002
                                          18. Minard V et al: Adverse outcome of infants with metastatic neuroblastoma, MYCN amplification and/or bone lesions: results of the French society of pediatric oncology. Br J Cancer. 83(8):973-9, 2000
                                          19. Perel Y et al: Clinical impact and prognostic value of metaiodobenzylguanidine imaging in children with metastatic neuroblastoma. J Pediatr Hematol Oncol. 21(1):13-8, 1999
                                          20. Shulkin BL et al: Current concepts on the diagnostic use of MIBG in children. J Nucl Med. 39(4):679-88, 1998
                                          21. Leung A et al: Specificity of radioiodinated MIBG for neural crest tumors in childhood. J Nucl Med. 38(9):1352-7, 1997
                                          22. Shulkin BL et al: Iodine-131-metaiodobenzylguanidine and bone scintigraphy for the detection of neuroblastoma. J Nucl Med. 33(10):1735-40, 1992
                                          Related Anatomy
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                                          Related Differential Diagnoses
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                                          References
                                          Tables

                                          Tables

                                          KEY FACTS

                                          • Terminology

                                            • Imaging

                                              • Pathology

                                                • Clinical Issues

                                                  • Diagnostic Checklist

                                                    TERMINOLOGY

                                                    • Definitions

                                                      • Embryonic tumor derived from primitive neural crest cells along peripheral sympathetic chain
                                                        • Primary tumor
                                                          • Along sympathetic chain
                                                            • ~ 30% adrenal medulla
                                                            • ~ 60% abdominal paraspinal ganglia
                                                          • Tends to infiltrate and surround; extends into neural foramina, encases vessels
                                                          • Variable calcification, tends to further calcify with therapy
                                                        • Metastases
                                                          • Bone, lymph nodes, liver, lung, brain, soft tissue

                                                    IMAGING

                                                    • F-18 FDG PET/CT Findings

                                                      • F-18 F-DOPA PET/CT Findings

                                                        • I-124 MIBG PET/CT Findings

                                                          • Nuclear Medicine Findings

                                                            • Other Modality Findings

                                                              DIFFERENTIAL DIAGNOSIS

                                                                PATHOLOGY

                                                                • General Features

                                                                  • Staging, Grading, & Classification

                                                                    • Gross Pathologic & Surgical Features

                                                                      • Microscopic Features

                                                                        CLINICAL ISSUES

                                                                        • Presentation

                                                                          • Demographics

                                                                            • Natural History & Prognosis

                                                                              • Treatment

                                                                                DIAGNOSTIC CHECKLIST

                                                                                • Consider

                                                                                  Selected References

                                                                                  1. Liu YL et al: Diagnostic FDG and FDOPA positron emission tomography scans distinguish the genomic type and treatment outcome of neuroblastoma. Oncotarget. 7(14):18774-86, 2016
                                                                                  2. Bleeker G et al: 123I-MIBG scintigraphy and 18F-FDG-PET imaging for diagnosing neuroblastoma. Cochrane Database Syst Rev. CD009263, 2015
                                                                                  3. Lee JW et al: Prognostic value of pretreatment FDG PET in pediatric neuroblastoma. Eur J Radiol. 84(12):2633-9, 2015
                                                                                  4. Gil TY et al: Clinical experience with (18)F-fluorodeoxyglucose positron emission tomography and (123)I-metaiodobenzylguanine scintigraphy in pediatric neuroblastoma: complementary roles in follow-up of patients. Korean J Pediatr. 57(6):278-86, 2014
                                                                                  5. Louis CU et al: Neuroblastoma: Molecular Pathogenesis and Therapy. Annu Rev Med. ePub, 2014
                                                                                  6. Lu MY et al: Characterization of neuroblastic tumors using 18F-FDOPA PET. J Nucl Med. 54(1):42-9, 2013
                                                                                  7. Mueller WP et al: Nuclear medicine and multimodality imaging of pediatric neuroblastoma. Pediatr Radiol. 43(4):418-27, 2013
                                                                                  8. Davidoff AM: Neuroblastoma. Semin Pediatr Surg. 21(1):2-14, 2012
                                                                                  9. Piccardo A et al: Comparison of 18F-dopa PET/CT and 123I-MIBG scintigraphy in stage 3 and 4 neuroblastoma: a pilot study. Eur J Nucl Med Mol Imaging. 39(1):57-71, 2012
                                                                                  10. Colon NC et al: Neuroblastoma. Adv Pediatr. 58(1):297-311, 2011
                                                                                  11. Cohn SL et al: The International Neuroblastoma Risk Group (INRG) classification system: an INRG Task Force report. J Clin Oncol. 27(2):289-97, 2009
                                                                                  12. Monclair T et al: The International Neuroblastoma Risk Group (INRG) staging system: an INRG Task Force report. J Clin Oncol. 27(2):298-303, 2009
                                                                                  13. Sharp SE et al: 123I-MIBG scintigraphy and 18F-FDG PET in neuroblastoma. J Nucl Med. 50(8):1237-43, 2009
                                                                                  14. Taggart DR et al: Comparison of iodine-123 metaiodobenzylguanidine (MIBG) scan and [18F]fluorodeoxyglucose positron emission tomography to evaluate response after iodine-131 MIBG therapy for relapsed neuroblastoma. J Clin Oncol. 27(32):5343-9, 2009
                                                                                  15. Ilias I et al: New functional imaging modalities for chromaffin tumors, neuroblastomas and ganglioneuromas. Trends Endocrinol Metab. 16(2):66-72, 2005
                                                                                  16. Juweid ME et al: 111In-pentetreotide versus bone scintigraphy in the detection of bony metastases of neuroblastoma. Nucl Med Commun. 23(10):983-9, 2002
                                                                                  17. Lonergan GJ et al: Neuroblastoma, ganglioneuroblastoma, and ganglioneuroma: radiologic-pathologic correlation. Radiographics. 22(4):911-34, 2002
                                                                                  18. Minard V et al: Adverse outcome of infants with metastatic neuroblastoma, MYCN amplification and/or bone lesions: results of the French society of pediatric oncology. Br J Cancer. 83(8):973-9, 2000
                                                                                  19. Perel Y et al: Clinical impact and prognostic value of metaiodobenzylguanidine imaging in children with metastatic neuroblastoma. J Pediatr Hematol Oncol. 21(1):13-8, 1999
                                                                                  20. Shulkin BL et al: Current concepts on the diagnostic use of MIBG in children. J Nucl Med. 39(4):679-88, 1998
                                                                                  21. Leung A et al: Specificity of radioiodinated MIBG for neural crest tumors in childhood. J Nucl Med. 38(9):1352-7, 1997
                                                                                  22. Shulkin BL et al: Iodine-131-metaiodobenzylguanidine and bone scintigraphy for the detection of neuroblastoma. J Nucl Med. 33(10):1735-40, 1992