Presented by

Rurry Diane Respati

 Introducing Neuroblastoma
Neuroblastoma is a rare disease, 13.000 new case of
childhood cancer in U.S only about 650 are
neuroblastoma(Children Nauroblastoma Cancer
Foundation, 2008).

In Indonesia, based on Jakarta hospital cancer

registration data in 2005. There are 7 %
Neuroblastoma case from all of childhood cancer
in the age of 0-17 years old. And the most
common cancer is leukeumia with 33,7%.
So…. What is
NEUROBLASTOMA ?
 Neuroblastoma is an embryonal tumor of the
autonomic nervous system that generally occur in
very young children, the median age at diagnosis
is 17 months (The New England Journal of
Medicine, 2010).

Neuroblastoma is a disease in which malignant

(cancer) cells form in nerve tissue of the adrenal
gland, neck, chest, or spinal cord.

.
Neuroblastoma often begin in
the nerve tissue of the adrenal
glands. There are two adrenal
glands, one on top of each
kidney in the back of the
upper abdomen
Bernard Horner Syndrom
The hallmark sign of
neuroblastoma, sinking
in of one eye ball,
ipsilateral ptosis, miosis,
anhidrosis and flushing
of the affected face
 Lump in the abdomen,
neck or chest

Bone pain
Swollen stomach and trouble breathing
in infants
Weakness or paralysis
 Painless, bluish lupms
under the skin in infants
Some tests to detect and
diagnose Neuroblastoma
Physical exam and history
Twenty-four-hour urine test
Blood chemistry studies
Cytogenetic analysis
Bone marrow aspiration and biopsy
X-ray
CT scan
Neurological exam
Ultrasound axam
Imunuhistochemistry study
Prognosis
The prognosis of neuroblatoma depends on:
The age of child when diagnosed
Stage of cancer
Where is the tumor is in the body
Tumor Histology
Tumor Biology
How fast the tumor cells are growing
 Stages in Neuroblastoma
Stage 1
The tumor is in only one area
The tumor that can be seen is completely
remove during surgery
Stage 2A
The tumor is in only one area
The tumor that can be seen cannot be
completely remove during surgery
Stage 2B
The tumor is in only one area
May be completely removed during surgery
Stage 3
Tumor cannot be completely removed during surgery
and has spread from one side to other side of the
body.
Tumor is in only one area, but has spread to lymph
nodes on the other side of the body
Tumor is in the middle of the body and has spread to
tissues or lymph nodes on both side of the body, and
cannot be removed by surgery.
Stage 4
Tumor has spread to distant lymph nodes, the skin,
or other parts of the body.
Stage 4S
The cancer has spread to the skin, liver, and/or
bone marror
The tumor is in only one area
All of the tumor that can be seen may be
completely removed during surgery
Cancer cells may be found in the lymph nodes
near the tumor.
The child is younger than 1 year
Treatment of Neuroblastoma