Slow-growing benign tumors with potential for functional disability in Neuroblastoma: a case study.

Background: Neuroblastoma (NBL) is the most common malignant extracranial tumor in pediatrics and may mature into ganglioneuroma (GN). Though GN is benign, it has the potential to cause severe symptoms related to adjacent structures or organs. Cases of GN causing complications such as scoliosis and hydronephrosis have been reported. We report a rare case of stage IV neuroblastoma which, over the course of 19 years, has presented as numerous GN tumors causing a striking number of complications. Case information: A 7 month-old male presented with stage IV NBL disseminated to his face, groin area, and testicles. The primary tumor was resected after chemotherapy treatment. Despite treatment efforts, disease spread to the bone marrow and numerous tumors appeared throughout the body. At the current age of 19, the patient has endured a lifetime of complications due to tumors in the face, spine, intestine, groin, and testicles. These complications include scoliosis, bowel obstruction, severe abdominal pain, hydronephrosis, varicocele, and neurologic symptoms. Conclusions: In more than half of patients, NBL is widely metastatic by the time it is diagnosed. Recurrence of NBL or GN is infrequent with complete tumor excision. However, due to the invasive character of NBL, it is difficult to ensure complete elimination of tumor cells. It is possible that the recurrent GN tumors appearing in this patient are the result of the maturation of what was initially metastasized, microscopic NBL lesions. Due to the rarity of such extensive GN dissemination, the pathology and management strategy of this condition is still being understood. Treatment of patients with NBL requires long-term, multidisciplinary management by experienced providers. Emphasis should be placed on quality of life. In addition, transfer of these patients from pediatric care to adult care requires extensive communication and education between the patient, family members, and all involved medical providers.