Case report demonstrates successful multimodal treatment in a child with multifocal primary neuroblastoma, suggesting favorable biological features in non-infantile cases.
Multifocal primary neuroblastoma in the non-infantile age group is rare, posing challenges in risk stratification and surgery. A 3-year-old girl presented with an abdominal mass and elevated urinary VMA (218 mg/l). PET-CT showed FDG-avid masses in the left suprarenal and posterior mediastinum with regional paraortic nodes. A biopsy of the suprarenal and thoracic masses was suggestive of ganglioneuroblastoma and ganglioneuroma. She was stratified as an intermediate risk, with the bone marrow being uninvolved and non-amplified MYCN. Gross tumor resection was achieved at all the sites after 2 cycles of neoadjuvant chemotherapy. She received 2 more cycles of adjuvant chemotherapy and has been disease-free for the last 3 years. Multifocal primaries in the non-infantile age group have favourable biological features and good outcomes.
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Rahmat et al. (2024) studied this question.
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