neuroblastoma | Neuroblastoma

Neuroblastoma



Neuroblastooma is an malignant tumor of the immature ( "juvenile ") cells formed by a malignancy (neuro = nerve, blast = very young cell, own = tumor). It is the most common in small, all five-year-old children and is found in Finland in approximately 10 cases per annum. Source? Neuroblastooma is the most common form of solid cancer in children immediately after brain tumors. [1] The clinical picture of Neuroblaasis is very broad: a small proportion of the diseases that are being treated will heal themselves, while in other children the disease is aggressive yes requires a drastic treatment of children to survive.

Neuroblastooma is not only the most common, but also studied childhood solid cancer. The majority of neuroblastosome patients aged more than one year have a poor prognosis. It is difficult to assess the malignancy of the tumour and the patient's survival forecast based on a single neuroblasty sample.

Contents

1 reasons

2 Symptoms

3 diagnosis

4 classification

4.1 Neuroblastooman Habitat Classification (international neuroblastoma staging System, Rosalie)

5 Treatment

5.1 Benign Neuroblastooma

5.2 Medium-predicted neuroblastoma

5.3 Poor Neuroblastooma

6. Recurrent or progressive disease

7 Other appearances

7.1 References

8 External links

Causes

The causes of Neuroblastoone are not known. Even the predisposing of the environmental factors has not been shown directly to predisposing bother specifically to the outbreak of Neuroblastone, but general, which predispose to cancer development, is expected to contribute to the emergence of Neuroblastone. Neuroblastoon has an inherited form, but it is very rare.

Symptoms

Neuroblasion symptoms depend very much on where the tumor or tumors are located. The parent tumor (primary) occurs most commonly in the stomach, pelvis, inside the chest (more precisely in the intermediate pens or mediarium) or on the neck. Neuroblastooma also transmits frequent metastases, and sometimes their growth causes the disease to be the first symptoms.

On the side of the children, neuroblastoma develops in the abdomen with an amillyical adrenal glands (a small, hormone-absorbing organ that is particularly rich in the sympathetic nervous system). In the abdominal area, neuroblastoma often feels like a large, not-for-an-arsty mass. Neuroblastoma in the neck is usually a small, non-slip-resistant stalemate. A chest tumour is usually a long-term symptom-free, and may be noticed by chance, for example, when a respiratory infection is resolved. When neuroblastoma is located in the midline area, it may increase from the spinal vertebrae to the spinal canal and press the spinal cord or nerves. As a result are lower limb paralysis symptoms, difficulty walking yes bowel movements and bladder function disorders. The treatment of neuroblastone growing in the spinal canal is always hard to avoid permanently damaging the spinal cord.

Neuroblastooma transmits metastasis (metastases) most commonly to the pumice bone and bone marrow. Bone metastases cause pain, allowing the child to reduce the risk of sick use. A small child may be itful and spiky. Sometimes the bone may even break (a pathological fracture) as a result of the growth of metastasis. The main function of bone marrow is to produce blood cells. Neuroblastoma is interfering with blood formation, resulting in abnormalities in the numbers of blood cells and symptoms resulting from these: anaemia, bleeding tendency (nosebleeds, bleeding gums, bruising) Yes sensitivity to inflammatory diseases. Babies with neuroblastoma are often in the skin as well as on the liver, which can grow to light and cause abdominal bottling. Skin metastases are bluish, broad-skinned dams, Mriganka are not sensitive.

In some rare cases, the tumor and/or the hormones it secreted can cause a certain number of symptoms in the children. The most common are the huge water diarrhea due to the excess of the VIP hormone and the so-called Opsoklonus-ataxia, jonkers symptoms are balance difficulties and special, jerky eye movements.

Diagnosis

A number of different research methods are used to diagnose the Yes prevalence. Below are the most common:
Urine examinations, such as the 24-hour urine collection. Neuroblastooma is often produced when it grows with homovaniline and vaniliic acid (HMA and VMA), which are excreted in the urine in higher quantities, the more active the tumor.
Different blood tests. Especially the high blood Dopamine and nororinephrine levels are common in neuroplasty.
Biopsy of the tumour.
A biopsy of the nearby lymph nodes to see if they have a tumour.
Bone marrow examination, which can be used to see the tumour spreading to the bone marrow.
Tumor area and/or abdominal ultrasound scan.
Tumor area, and usually also abdominal, thoracic and skeletal X-rays.
Computed tomography (TT) of the body or of the tumour area alone.
Magnetic resonance imaging (MRI) of the body or the tumor area alone.
Isotope studies such as MIBG (metajodobzylguanidine)-description and skeletal map. In isotope studies, the child's bloodstream is given a small amount of radioactive tracer attached to the Aineenvaihdunnallisesti important compound, in this case, a substance that is used in particular by neuroblastoyourcells. The tracer accumulates in this tumor, and the area is clearly visible in the images captured by the so-called gamma camera.
A study by a neurologist seeking to establish any neurological changes caused by the disease, such as a preliminary confirmation or exclusion of the spread of the disease to the spinal canal.
Rate
Neuroblastooma is classified according to its habitat as well as its biologists in different groups. The range of Neuroblastooman is described in the table below. Neuroblastoon biology refers to the properties of cancer cells, the main appearance and genetic of cells.

Neuroblastooma Habitat Classification (international Neuroblastema staging System, INSS)
Stage I

The tumor is only in one area and all visible cancer tissue is possible to remove the hairstyle completely.

Stage II

IIA: The tumor is only in one area, but all visible cancer tissue cannot be completely removed by surgery.

IIB: The tumor is only in one area, and any visible cancer tissue may be able to be removed by surgery. The tumor has spread to nearby lymph nodes.

Stage III

-The tumor cannot be completely removed by surgery and it is on both sides of the body and possibly in nearby lymph nodes or-the tumor is only in one area on the other side of the body, but it has spread to the other side of the lymph nodes or-tumor In the midline area, spread on both sides of the lymph nodes or tissues and it is not possible to remove it by surgery.

Stage IV

IV: The tumor has spread to distant lymph nodes, skin or other parts of the body.

IV S: Local, I-II stage – tumor that has spread to the liver, skin and/or bone marrow (less than 10% of the cells) but not to the bone. Age less than 1 year.

Neuroblastooma is a biologically very diverse tumor, and many of the traits given in the Patholog report are not necessarily known enough to be able to be seen to affect the child's prognosis with improvement or deterioration. The main biological prognosis is:

The histology of cells, that is, what they look like under a microscope. The histology of Neuroblaontocell can be "favorable" or "unfavorable".

The cell's matonal rate, i.e. how ripe the cells are. A mature tumor grows at a slower rate than is very immature and therefore has a better prognosis.

Cell mutagens, such as chromosome numbers and presence, absence or multiplication of certain genes. The most important of these are the very large number of chromosomes and the multi-seating of the N-myc gene, both of which have a worsening meaning of prognosis.

Treatment

When suspicion of malignant tumors arises, the child is sent to the nearest University hospital to confirm the diagnosis, to determine the prevalence of the disease and to initiate treatment. When deciding how to approach a treatment, we often talk about the child's prediction or prognosis, which means the child's ability to cope with their disease.

For the treatment of the child, neuroblastoma is placed in one of the three groups of the disease, according to biology and prevalence, which are spoken as groups of good-middle and poor prognosis. Forecast means the child's ability to cope with their disease. The main factors influencing the prognosis are the age of the child, the histology of tumor cells, the existence of the so-called N-myc gene monomer and the degree of disease spread. Neuroblastoon's main treatment lines are surgery, cytostaatti and radiotherapy.

Benign neuroblastoma

Neuroblastooma belongs to this group where it is present in stage 1 or in many of the pauses for stage 2, its histology (what the cells look like in the microscope) is favorable and there is no duplication of the N-myc gene. The majority of 4s patients also have a good prognosis for the disease. 30% of the Neuroblastoform children belong to this group and they heal practically everything.

Adequate treatment of a well-predicted patient is a tumour removal surgery. After this, the child will be monitored for a few years to ensure that the tumor is not going to come back. If the child is asymptomatic or the tumor grows in a dangerous place (e.g., presses the spinal cord) may he or she will receive short, low-dose cytostaattitherapy or, if this is not enough, radiation therapy. If it is a baby of 4s-stage, you may not even need surgical treatment, as the tumor often loses completely to himself by the age of 1 to 2 years. If the tumor mass, for example, in the liver is huge and interferes with its presence in other organs, it can sometimes shrink with cytostaattherapy. When metastases are called Spontaneous regression or loss has occurred, the remaining tumor can be surgically removed. The child's well-being and the loss of the tumor are monitored by regular medical visits while the disease is in progress and for some time after healing.

Medium-predicted Neuroblastoma

The group includes some stage 2 patients as well as stage 3 patients with favourable disease histology and no duplicate of the N-myc gene. The group also includes very small patients with severe symptomatic stage 4s, as well as patients under 1 year of age 4-stage with no N-myc multiseating. Approximately 15% of patients are affected by neuroblastoone.

The treatment is short, 3 to 5 months of chemotherapy and possibly radiotherapy for the tumour area, for example, if the tumor does not shrink quickly enough or its location causes problems. When the tumor is reduced to the appropriate size, it is removed. The forecast for the medium-term neuroblastone is good – it improves on average between 70 and 80% of sufferers, but there seems to be a large variation within the group.

Poor neuroblastoma

A low-predicted neuroblasty group includes all patients over 2-stage, who are over a year old with either N-myc – multiseating or unfavorable tumor histology as well as those of stage 2 patients who are over one year old, and who have both N-myc – Multiseating that unfavorable for tumor histology. In addition, babies aged less than one year and with N-Myc monseating are also included in this category. In 4-stage patients, a poor prediction group includes all those over 1.5 years of age, and those under half years of age with a multiseating of the MYC gene. Half of Neuroblastoon sufferers have poor prognosis in patients.

Treatment with a low-predicted neuroblastocone consists of several violent cytostaattites, which aim to shrink the parent-i.e. primary-to-surgical size and eradicate metastases that grow elsewhere. Metastases are often so abundant that it is impossible to remove them surgically, but in almost every case they react to cytostaattherapy at least partially. Treatment with low-predicted Neuroblastoon is discontinued. With autologous stem cell transplantation, a potent cytostaattiis so strong that it permanently destroys the blood-forming tissue of the child's bone marrow. Blood formation is re-launched from the child at an earlier stage of treatment.

Recurrent or progressive disease

Because neuroblastoma is a very aggressive tumor, it is not unusual for it to recur or proceed despite treatment. When the disease continues to progress or recurs, the growth of the tumor stops and the tumour mass is reduced by stronger cytostaattifirts. It is then normally attempted to give the left treatment by autologous stem cell transplantation and thus eradicate the disease altogether. Sometimes experimental therapies may also be attempted: such as "Double-tranplanates", which give the child two treatment with stem cell transplantation. However, if a child's disease has recurrent or is still progressing after a stem cell transplant, the child will die in practice at all times, in which case the treatment of cure makes sense to stop and, instead, to start palliative care.