Fetal neuroblastoma: case report

Authors

  • Caio Siqueira Nebesniak Hospital Universitário São Francisco na Providência de Deus – HUSF. Bragança Paulista, SP
  • Attilio Brisighelli Neto Hospital Universitário São Francisco na Providência de Deus – HUSF. Bragança Paulista, SP

DOI:

https://doi.org/10.37497/JMRReview.v1i1.17

Keywords:

Fetal Neuroblastoma, Case Report, Obstetrics, Diagnostic Imaging

Abstract

Background: Neuroblastoma is a tumor of poorly differentiated embryonic nerve cells. Although most commonly found in the adrenal gland (90%), it can also be found in the posterior mediastinum or along the sympathetic neural chain. Furthermore, congenital neuroblastoma is the second most common tumor in the neonatal period, corresponding to 20% of all congenital tumors. Aim: To report a case of fetal neuroblastoma diagnosed in our Service.

Case report: It was a pregnancy where the patient had gestational diabetes mellitus and gestational age of 38 weeks and 3 days. The fetus, according to morphological ultrasonography (USG), presented a tumor lesion in its right adrenal gland, in addition to macrosomia. Due to the observed results, a cesarean delivery was performed, without intercurrences. At postpartum USG, the tumor lesion remained, however, no clinical repercussions were observed. The newborn was discharged from the Service with outpatient referral to the pediatric surgery team, and a third USG showed a solid-cystic lesion in his right adrenal gland measuring 2.8 x 2.7 x 2.0 cm, still without clinical repercussions.

Conclusion: Fetal neuroblastoma has an excellent prognosis, and reports of spontaneous tumor remission are common. However, caution is required when dealing with this type of tumor, as it is possible that in utero metastases or compression of the fetal/newborn spinal cord may occur. The importance of prenatal imaging tests, mainly USG and magnetic resonance imaging, is highlighted for the prior identification of neuroblastoma, and postpartum for the identification of tumor staging. Furthermore, tumors classified as 4S have a better prognosis, with the possibility of spontaneous remission.

Author Biographies

Caio Siqueira Nebesniak , Hospital Universitário São Francisco na Providência de Deus – HUSF. Bragança Paulista, SP

Serviço de Ginecologia e Obstetrícia. Hospital Universitário São Francisco na Providência de Deus – HUSF. Bragança Paulista – SP.

Attilio Brisighelli Neto, Hospital Universitário São Francisco na Providência de Deus – HUSF. Bragança Paulista, SP

Serviço de Ginecologia e Obstetrícia. Hospital Universitário São Francisco na Providência de Deus – HUSF. Bragança Paulista – SP.

References

AMLER, L. C. et al. Identification and characterization of novel genes located at the t(1;15)(p36.2;q24) translocation breakpoint in the neuroblastoma cell line NGP. Genomics, v. 64, n. 2, p. 195–202, 1 mar. 2000. DOI: https://doi.org/10.1006/geno.1999.6097

CHEN, C. P. et al. Clinical and perinatal sonographic features of congenital adrenal cystic neuroblastoma: a case report with review of the literature. Ultrasound in Obstetrics & Gynecology: The Official Journal of the International Society of Ultrasound in Obstetrics and Gynecology, v. 10, n. 1, p. 68–73, jul. 1997. DOI: https://doi.org/10.1046/j.1469-0705.1997.10010068.x

DAVIS, J. et al. Diagnosis of neonatal neuroblastoma with postmortem magnetic resonance imaging. Radiology Case Reports, v. 12, n. 1, p. 191–195, mar. 2017. DOI: https://doi.org/10.1016/j.radcr.2016.08.019

DELAHAYE, S. et al. Prenatal diagnosis of dumbbell neuroblastoma. Ultrasound in Obstetrics & Gynecology: The Official Journal of the International Society of Ultrasound in Obstetrics and Gynecology, v. 31, n. 1, p. 92–95, jan. 2008. DOI: https://doi.org/10.1002/uog.5148

DEMARCO, R. T. et al. Congenital neuroblastoma: a cystic retroperitoneal mass in a 34-week fetus. The Journal of Urology, v. 166, n. 6, p. 2375, dez. 2001. DOI: https://doi.org/10.1016/S0022-5347(05)65593-0

ELSAYES, K. M. et al. Adrenal masses: mr imaging features with pathologic correlation. Radiographics: A Review Publication of the Radiological Society of North America, Inc, v. 24 Suppl 1, p. S73-86, out. 2004. DOI: https://doi.org/10.1148/rg.24si045514

FISHER, J. P. H.; TWEDDLE, D. A. Neonatal neuroblastoma. Seminars in Fetal & Neonatal Medicine, v. 17, n. 4, p. 207–215, ago. 2012. DOI: https://doi.org/10.1016/j.siny.2012.05.002

FORMAN, H. P. et al. Congenital neuroblastoma: evaluation with multimodality imaging. Radiology, v. 175, n. 2, p. 365–368, maio 1990. DOI: https://doi.org/10.1148/radiology.175.2.2183280

KOESTERS, R. et al. Human eukaryotic initiation factor EIF2C1 gene: cDNA sequence, genomic organization, localization to chromosomal bands 1p34-p35, and expression. Genomics, v. 61, n. 2, p. 210–218, 15 out. 1999. DOI: https://doi.org/10.1006/geno.1999.5951

KÖKSAL, Y. et al. Bilateral adrenal cystic neuroblastoma with hepatic and splenic involvement in a newborn. Journal of Pediatric Hematology/Oncology, v. 27, n. 12, p. 670–671, dez. 2005. DOI: https://doi.org/10.1097/01.mph.0000193470.91690.bd

LEE, S. Y. et al. Congenital bilateral cystic neuroblastoma with liver metastases and massive intracystic haemorrhage. The British Journal of Radiology, v. 71, n. 851, p. 1205–1207, nov. 1998. DOI: https://doi.org/10.1259/bjr.71.851.10434918

LONERGAN, G. J. et al. Neuroblastoma, ganglioneuroblastoma, and ganglioneuroma: radiologic-pathologic correlation. Radiographics: A Review Publication of the Radiological Society of North America, Inc, v. 22, n. 4, p. 911–934, ago. 2002. DOI: https://doi.org/10.1148/radiographics.22.4.g02jl15911

LUIS, A. L. et al. [Congenital neuroblastomas]. Cirugia Pediatrica: Organo Oficial De La Sociedad Espanola De Cirugia Pediatrica, v. 17, n. 2, p. 89–92, abr. 2004.

OMOSEEBI, O. et al. Neonatal neuroblastoma with adrenal primary and metastasis to the liver: A case report and a review of literature. African journal of paediatric surgery: AJPS, v. 13, n. 4, p. 217–222, dez. 2016. DOI: https://doi.org/10.4103/0189-6725.194674

SUL, H. J.; KANG, D. YOUNG. Congenital neuroblastoma with multiple metastases: a case report. Journal of Korean Medical Science, v. 18, n. 4, p. 618–620, ago. 2003. DOI: https://doi.org/10.3346/jkms.2003.18.4.618

TIAN, C.; CHEN, L.; ZHU, C. [An adrenal neuroblastoma regression diagnosed and followed by ultrasound: a case report]. Zhong Nan Da Xue Xue Bao. Yi Xue Ban = Journal of Central South University. Medical Sciences, v. 42, n. 2, p. 233–235, 28 fev. 2017.

WERNER, H. et al. Fetal neuroblastoma: ultrasonography and magnetic resonance imaging findings in the prenatal and postnatal IV-S stage. Obstetrics & Gynecology Science, v. 59, n. 5, p. 407–410, 2016. DOI: https://doi.org/10.5468/ogs.2016.59.5.407

Published

2022-11-23

How to Cite

Nebesniak , C. S., & Neto, A. B. (2022). Fetal neuroblastoma: case report. Journal of Medical Residency Review, 1(1), e017. https://doi.org/10.37497/JMRReview.v1i1.17