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Clinical Problem Solving: Pathology
February 2005

Pathology Quiz Case 1—Diagnosis

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Arch Otolaryngol Head Neck Surg. 2005;131(2):174-175. doi:10.1001/archotol.131.2.174

Neuroblastoma is a malignant tumor consisting of undifferentiated neuroectodermal cells of neural crest origin. It is the most common malignancy of infancy and the most frequently diagnosed extracranial solid tumor in children younger than 5 years.1,2 It is an aggressive neoplasm that is capable of both hematogenous and lymphatic metastasis, and it is responsible for 15% of pediatric cancer-related deaths despite representing only 8% to 10% of pediatric malignancies.1,3 The tumors are derived from neural crest cells associated with the sympathetic nervous system, and most are located in the adrenal medulla (75%-90%) and thoracoabdominal sympathetic ganglia (10%-15%).4,5 Only 2% to 5% of primary NBs are of cervical origin, and many of the NBs that present in the head and neck region represent metastatic disease.4,5

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