Paravertebral Widening in Cases of Neuroblastoma

Retroperitoneal paravertebral widening is an ominous prognostic sign when it appears in a child suspected of having a neuroblastoma. Of a series of 100 patients with histologically confirmed neurablastoma, 27 had paravertebral widening and of this latter group only two children were considered to be cured. 70 per cent of patients with paravertebral widening followed for a sufficient time survived less than six months after the diagnosis was established. The paravertebral widening has been found to be due both to direct contiguous extension of the tumour and also to foci of retroperitoneal metastases. The paravetebral widening was searched for and not seen in any of 100 consecutive normal paediatric chest radiographs or in any of a series of 37 Wilms' tumour cases. Although it is not a pathognomonic sign of neuroblastoma, it is of critical diagnostic importance in the evalutaion of the child with an abdominal mass.