Neuroblastoma is primarily a disease of infants and children. It is not rare, since some 700 cases are reported in the literature. Among the malignancies of children it is probably second only to leukemia.
The features of this disease have been reported in detail by others.2,8,10,12,14,15,18
The tumor may arise from any part of the sympathetic nervous system, but the usual site is the adrenal gland. The commonest sites of metastasis are the skeleton and the liver, but the concept that skeletal metastasis accompanies a primary left adrenal tumor (Hutchison syndrome) and liver metastasis, a right adrenal tumor (Pepper syndrome), as suggested by Frew,5 has repeatedly been refuted.7,8,10,11 The usual presenting sign is progressive enlargement of the upper abdomen caused by the primary tumor, liver metastases, retroperitoneal nodal metastases, ascites or combinations of these. Among the skeletal metastases, those to the skull are most frequent and may
CHAO J, NELSON PA, SCHMITZ RL, CHRISTIAN JR. Survival After Neuroblastoma with Widespread Metastasis. AMA Am J Dis Child. 1959;97(2):223–227. doi:10.1001/archpedi.1959.02070010225012
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