Dilemmas in the Management of an Infant with Neuroblastoma Metastasized to the Muscles
The risk stratification of infants with metastatic neuroblastoma (NB) has evolved over time from stage 4/M or IVs/4S/MS/Ms according to various staging systems. Despite these developments for some genetic aberrations, the prognostic value and the impact of soft tissue metastases in infants are not f...
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| Format: | Article |
| Language: | English |
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Karger Publishers
2023-07-01
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| Series: | Case Reports in Oncology |
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| Online Access: | https://beta.karger.com/Article/FullText/531433 |
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| author | Jaques van Heerden Machiel van den Akker Joris Verlooy Nadine Van Roy Geneviève Laureys Koen Norga |
| author_facet | Jaques van Heerden Machiel van den Akker Joris Verlooy Nadine Van Roy Geneviève Laureys Koen Norga |
| author_sort | Jaques van Heerden |
| collection | DOAJ |
| description | The risk stratification of infants with metastatic neuroblastoma (NB) has evolved over time from stage 4/M or IVs/4S/MS/Ms according to various staging systems. Despite these developments for some genetic aberrations, the prognostic value and the impact of soft tissue metastases in infants are not fully understood, nor well described in the different classification systems, hampering the definitions to uniformly treat patients and predict prognosis. A literature review on staging of infants with M/MS disease was performed at the occasion of the diagnosis of NB in an 8-month-old boy who presented with atypical metastatic sites in soft tissue and an aberrant tumor biology. The definitions of stage 4/4S/4s/M/MS/Ms were evaluated and compared to enable tumor risk stratification and inform management. International NB groups use different criteria for defining stage of infants with metastasized NB, resulting in differences in management. Limited literature is available on soft tissue metastases, especially muscular metastases, and is poorly incorporated into management guidelines mainly due to the lack of data. The uncertain prognosis of rare genetic aberrancies may add to the difficulties in treatment decisions. In some rare cases of NB in infants, the international treatment classification is not sufficient for staging and treatment decisions. Based on tumor progression, biology of unknown significance and a lack of evidence to classify a child under 12 months with NB and multiple muscular metastases, the patient was treated as stage 4/M and intermediate-risk protocols with a favorable outcome. |
| first_indexed | 2024-03-12T13:31:11Z |
| format | Article |
| id | doaj.art-1f18a9f4221642848a45fb72448be1ad |
| institution | Directory Open Access Journal |
| issn | 1662-6575 |
| language | English |
| last_indexed | 2024-03-12T13:31:11Z |
| publishDate | 2023-07-01 |
| publisher | Karger Publishers |
| record_format | Article |
| series | Case Reports in Oncology |
| spelling | doaj.art-1f18a9f4221642848a45fb72448be1ad2023-08-24T09:41:54ZengKarger PublishersCase Reports in Oncology1662-65752023-07-0116155256110.1159/000531433531433Dilemmas in the Management of an Infant with Neuroblastoma Metastasized to the MusclesJaques van Heerden0https://orcid.org/0000-0002-4502-1169Machiel van den Akker1Joris Verlooy2Nadine Van Roy3Geneviève Laureys4Koen Norga5Department of Pediatric Haematology and Oncology, Antwerp University Hospital, Antwerp, BelgiumDepartment of Pediatric Haematology and Oncology, Antwerp University Hospital, Antwerp, BelgiumDepartment of Pediatric Haematology and Oncology, Antwerp University Hospital, Antwerp, BelgiumCancer Research Institute Ghent (CRIG), Ghent University, Ghent, BelgiumCancer Research Institute Ghent (CRIG), Ghent University, Ghent, BelgiumDepartment of Pediatric Haematology and Oncology, Antwerp University Hospital, Antwerp, BelgiumThe risk stratification of infants with metastatic neuroblastoma (NB) has evolved over time from stage 4/M or IVs/4S/MS/Ms according to various staging systems. Despite these developments for some genetic aberrations, the prognostic value and the impact of soft tissue metastases in infants are not fully understood, nor well described in the different classification systems, hampering the definitions to uniformly treat patients and predict prognosis. A literature review on staging of infants with M/MS disease was performed at the occasion of the diagnosis of NB in an 8-month-old boy who presented with atypical metastatic sites in soft tissue and an aberrant tumor biology. The definitions of stage 4/4S/4s/M/MS/Ms were evaluated and compared to enable tumor risk stratification and inform management. International NB groups use different criteria for defining stage of infants with metastasized NB, resulting in differences in management. Limited literature is available on soft tissue metastases, especially muscular metastases, and is poorly incorporated into management guidelines mainly due to the lack of data. The uncertain prognosis of rare genetic aberrancies may add to the difficulties in treatment decisions. In some rare cases of NB in infants, the international treatment classification is not sufficient for staging and treatment decisions. Based on tumor progression, biology of unknown significance and a lack of evidence to classify a child under 12 months with NB and multiple muscular metastases, the patient was treated as stage 4/M and intermediate-risk protocols with a favorable outcome.https://beta.karger.com/Article/FullText/531433neuroblastomasoft tissue metastasisrisk stratificationinfantcase report |
| spellingShingle | Jaques van Heerden Machiel van den Akker Joris Verlooy Nadine Van Roy Geneviève Laureys Koen Norga Dilemmas in the Management of an Infant with Neuroblastoma Metastasized to the Muscles Case Reports in Oncology neuroblastoma soft tissue metastasis risk stratification infant case report |
| title | Dilemmas in the Management of an Infant with Neuroblastoma Metastasized to the Muscles |
| title_full | Dilemmas in the Management of an Infant with Neuroblastoma Metastasized to the Muscles |
| title_fullStr | Dilemmas in the Management of an Infant with Neuroblastoma Metastasized to the Muscles |
| title_full_unstemmed | Dilemmas in the Management of an Infant with Neuroblastoma Metastasized to the Muscles |
| title_short | Dilemmas in the Management of an Infant with Neuroblastoma Metastasized to the Muscles |
| title_sort | dilemmas in the management of an infant with neuroblastoma metastasized to the muscles |
| topic | neuroblastoma soft tissue metastasis risk stratification infant case report |
| url | https://beta.karger.com/Article/FullText/531433 |
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