Anatomic Site

Clinical manifestations depend on the anatomic site of the primary tumor:

1. Head and neck: Unilateral palpable mass

Horner syndrome (meiosis, ptosis, enophthalmos, anhydrosis)

2. Orbit and eye:

Orbital secondaries with periorbital hemorrhage ("raccoon eyes") Exophthalmos, palpable supraorbital masses, ecchymosis, edema of eyelids and conjunctiva, ptosis

Cerebral involvement: papilledema, retinal hemorrhage, optic atrophy, paresis of the external rectus muscle, and strabismus

Cervical sympathetic involvement: heterochromia iridis, anisocoria, Horner syndrome

Opsoclonus ("dancing eyes syndrome")

Upper thoracic tumors: dyspnea, pulmonary infections, dysphagia, lymphatic compression, Horner syndrome

Lower thoracic tumors: usually no symptoms

4. Abdomen: Anorexia, vomiting Abdominal pain Palpable mass

Massive involvement of the liver with metastatic disease with or without respiratory distress especially in the newborn

5. Pelvis: Constipation Urinary retention

Presacral mass palpable on rectal examination

6. Paraspinal area (dumbbell- or hourglass-shaped neuroblastoma): Localized back pain and tenderness

Limp

Weakness of lower extremities

Hypotonia, muscle atrophy, areflexia, or hyperreflexia of lower extremities

Paraplegia

Scoliosis

Bladder and anal sphincter dysfunction

7. Lymph nodes: enlarged

8. Bone: pain, limping, and irritability in the young child associated with bone and bone marrow metastases.

9. Lung: lungs and pleura are rarely involved; incidence of 0.7% in all patients with neuroblastoma; because of its rarity, lung involvement should be proven by biopsy

10. Brain: rarely, metastatic involvement of the brain can occur.

Was this article helpful?

0 0
Constipation Prescription

Constipation Prescription

Did you ever think feeling angry and irritable could be a symptom of constipation? A horrible fullness and pressing sharp pains against the bladders can’t help but affect your mood. Sometimes you just want everyone to leave you alone and sleep to escape the pain. It is virtually impossible to be constipated and keep a sunny disposition. Follow the steps in this guide to alleviate constipation and lead a happier healthy life.

Get My Free Ebook


Post a comment