Symptoms of Neuroblastoma

Most symptoms of the childhood cancer, neuroblastoma, are caused by the growth of the cancer into nearby tissues or organs, or its spread to distant parts of the body such as bones or bone marrow.

Neuroblastoma symptoms may include:

• lump or swelling in the abdomen (belly), neck or chest, or under the skin
• stomach pain, feeling full or not wanting to eat, usually with weight loss
• swelling in the arms or legs (if a tumour is pressing on blood vessels or lymph vessels)
• problems going to the toilet (if the cancer grows into the bladder or bowel)
• bulging eyes, or dark circles around the eyes jerky, uncontrolled eye movements
• bone pain
• other unexplained pain weakness or paralysis (if the cancer is pressing on the nerves or spinal cord)
• trouble breathing or swallowing.

In some cases, neuroblastoma produces certain hormones that can cause diarrhoea, high blood pressure, rapid heartbeat, sweating and flushing of the skin.

Note about symptoms

Many conditions – including common childhood infections – can cause these symptoms, not just neuroblastoma. If your child has any of these symptoms and you are concerned, talk to your child’s doctor.

Neuroblastoma diagnosis

Your child will have a number of tests to investigate their symptoms and confirm a diagnosis of neuroblastoma, including:

• medical history and physical examination
• blood tests
• urine tests
• medical imaging, which may include:
  • X-ray
  • Ultrasound
  • computed tomography (CT) scan
  • magnetic resonance imaging (MRI)
  • bone scan
  • metaidobenzylguanidine (MIBG) scan
  • positron emission tomography (PET) scan
• biopsy – where a small sample of the cancer is removed to be examined under a microscope.The sample can also be tested for genetic changes that can help determine the best type of treatment for your child
• bone marrow aspiration and biopsy – where a sample of bone marrow is taken with a small piece of bone to be examined under a microscope. This is done from 2 separate places in the body at the same time (called a bilateral bone marrow aspiration).

Your child will probably have more than one of these tests.

The tests are designed to diagnose neuroblastoma, as well as determine the size of the tumour, its exact location in the body and whether it has spread to other parts of the body. The most commonplaces it spreads to are the lymph nodes, liver, bones and bone marrow, and sometimes the skin.

Neuroblastoma stages

If your child is diagnosed with neuroblastoma, some of the diagnostic tests will also help to stage the tumour. Staging determines where the tumour is, how big it is, which nearby organs are involved and whether the cancer has spread to other parts of the body. This is important to determine the outlook (prognosis) for your child, and to decide on the best options for treatment.

There are different ways of staging neuroblastoma – the following is the most commonly used: