Peds Exam 4- Neuroblastoma

Neuroblastoma

tumor in the adrenal medulla that affects sympathetic nervous system (fight or flight)

Neuroblastoma mets sights

Bone Marrow, Lymph Nodes, Liver, Lungs, Skin, Bone, Eyes, Spinal Cord

Neuroblastoma symp

large abdominal mass, bulging racoon eyes, opsoclonus (uncontrolled eye movements) lumps in neck/chest, painless firm blue lumps under skin(blueberries),increase BP, Temp, decrease wt, fatigue, abnormal sweating

Neuroblastoma labs

Urine with UMA and HVA, N-myc (MYCN) levels, low PLT, RBC &WBC

N-myc

genetic marker- positive= worse outcome

Neuroblastoma Dx

CT, MRI, Bone marrow aspiration, MIBG scan

MIBG scan

Iodine and IV Radioactive isotope given need to sedate. Radioisotype is more absorbed into areas of tumor

Indicators of good prognosis

Age (less than 1) and Negative N-myc levels

Stage 4S

< 1yo(Skin, liver, & BM,but no bone mets)

Late stage of IICP

Cushing Triad- increased BP, decreased pulse and respirations

Neuroblastoma tx

Surgery, chemo, radiation, Vit/Retin A, Stem cells/bone marrow transplants, accutane