neuroblastoma

Neuroblastoma is a type of cancer that forms in nerve cells called neuroblasts. Neuroblasts are immature nerve tissue. They normally turn into working nerve cells. But in neuroblastoma, they form a tumor.

Neuroblastoma usually begins in the adrenal glands. You have two adrenal glands, one on top of each kidney. The adrenal glands make important hormones that help control heart rate, blood pressure, blood glucose (blood sugar), and the way the body reacts to stress. Neuroblastoma may also begin in the neck, chest or spinal cord.

Neuroblastoma is caused by changes in your genes. Gene changes also called gene variants or mutations. In most cases, the cause of the mutation is unknown. In some other cases, the mutation is passed from the parent to the child.

Neuroblastoma often begins in early childhood. Sometimes it begins before a child is born.The most common symptoms are caused by the tumor pressing on nearby tissues as it grows or by cancer spreading to the bone.They include:

• A lump in the abdomen, neck, or chest
• Bulging eyes
• Dark circles around the eyes
• Bone pain
• Swollen stomach and trouble breathing in babies
• Painless, bluish lumps under the skin in babies
• Weakness or paralysis (loss of ability to move a body part)

To diagnose neuroblastoma, your child's health care provider will do various tests and procedures, which may include:

• A medical history.
• A neurological exam.
• Imaging tests, such as x-rays, a CT scan, an ultrasound, an MRI, or an MIBG scan. In an MIBG scan, a small amount of a radioactive substance is injected into a vein. It travels through the bloodstream and attaches itself to any neuroblastoma cells. A scanner detects the cells.
• Blood and urine tests.
• Biopsy, in which a sample of tissue is removed and examined under a microscope.
• Bone marrow aspiration and biopsy, in which bone marrow, blood, and a small piece of bone are removed for testing.

The treatments for neuroblastoma include:

• Observation, also called watchful waiting, is where the health care provider does not give any treatments until your child's signs or symptoms appear or change.
• Surgery
• Radiation therapy.
• Chemotherapy.
• High-dose chemotherapy and radiation therapy with stem cell rescue. Your child will get high doses of chemotherapy and radiation. This kills the cancer cells, but it also kills healthy cells. So your child will get a stem cell transplant, usually of his or her own cells collected earlier. This helps to replace the healthy cells that were lost.
• Iodine 131-MIBG therapy, a treatment with radioactive iodine. The radioactive iodine collects in neuroblastoma cells and kills them with the radiation that is given off.
• Targeted therapy, which uses drugs or other substances that attack specific cancer cells with less harm to normal cells.

NIH: National Cancer Institute

Your adrenal, or suprarenal, glands are located on the top of each kidney. These glands produce hormones that you can't live without, including sex hormones and cortisol, which helps you respond to stress and has many other functions.

A number of disorders can affect the adrenal glands, including tumors. Tumors can be either benign or malignant. Benign tumors aren't cancer. Malignant ones are. Most adrenal gland tumors are benign. They usually do not cause symptoms and may not require treatment. Malignant adrenal gland cancers are uncommon.

Types of tumors include:

• Adrenocortical carcinoma - cancer in the outer part of the gland
• Neuroblastoma, a type of childhood cancer
• Pheochromocytoma - a rare tumor that is usually benign

Symptoms depend on the type of cancer you have. Treatments may include surgery, chemotherapy, or radiation therapy.

Your adrenal glands are two small organs that sit on top of each kidney. The adrenal glands make different types of hormones you need to stay alive and healthy. Hormones are chemicals that travel in your bloodstream and control how different parts of your body work.

The adrenal glands make the hormones cortisol, aldosterone, adrenaline, and noradrenaline. They also make hormones that your body uses to make sex hormones (estrogen and testosterone). All of these hormones do many important jobs, including:

• Turning food into energy and managing blood sugar levels
• Balancing salt and water
• Keeping blood pressure normal
• Responding to illness and stress (your "fight or flight" response)
• Timing when and how fast a child develops sexually
• Supporting pregnancy

When you have an adrenal gland disorder, your body makes too much or too little of one or more hormones. The symptoms depend on the type of problem you have and how much it affects the hormone levels in your body.

There are many types of adrenal gland disorders, including:

• Addison's Disease - a condition in which the adrenal glands don't make enough cortisol
• Cushing's Syndrome - a condition caused by too much cortisol in the body, often from taking steroid medicines for a long time
• Aldosterone-producing adenoma - a benign tumor (not cancer) that makes too much aldosterone and may cause serious high blood pressure
• Hereditary paraganglioma-pheochromocytoma - an inherited condition causing different types of tumors that make adrenaline and other hormones. Some tumors may become cancerous.
• Adrenal gland cancer - cancerous tumors, including adrenocortical carcinoma and neuroblastoma
• Congenital Adrenal Hyperplasia (CAH) - a group of inherited disorders in which the adrenal glands don't make enough cortisol. The most common type is 21-hydroxylase deficiency (also called CAH1). In the United States, newborn babies get a blood test to see if they have CAH. People born with CAH may not have symptoms until childhood or later in life.

The cause of adrenal gland disorders depends on the type of disorder you have. Causes can include:

• Medicines such as steroids
• A problem in another gland, such as the pituitary gland. The pituitary gland releases hormones that affect how the adrenal glands work.
• Changes in genes (mutations). These changes can cause the adrenal glands to make too much or too little of one or more hormones.
• Infections

In many cases the cause of the problem isn't clear.

Health care providers use different tests to check for adrenal disorders depending on your symptoms and health history. For example, you may have tests of your blood, urine (pee), or saliva (spit). These tests check your hormone levels. Your provider may order x-rays, CT scans, or MRI scans to look for tumors.

Different types of adrenal gland disorders have different treatments. They include medicines and surgery. Radiation therapy is sometimes a treatment for tumors. There are treatments to cure certain adrenal gland disorders. For other disorders, treatments can manage your symptoms.

NIH: National Institute of Child Health and Human Development

Cancer is a group of related diseases. In all types of cancer, some of the body's cells begin to divide without stopping and spread into surrounding tissues.

Normally, new cells form as you need them, replacing old cells that die. Sometimes, this process goes wrong. New cells form when you don't need them, and old cells don't die when they should. The extra cells can form a tumor. Tumors can be benign or malignant. Benign tumors aren't cancer. Malignant tumors are cancer, and the cancer cells can spread to nearby tissues. They can also break away and spread to other parts of the body.

Children can get cancer in the same parts of the body as adults, but there are differences. Childhood cancers may happen suddenly, without early symptoms. Some types can often be cured. The most common children's cancer is leukemia. Some of the other more common types of cancer in children include brain tumors, lymphoma, and soft tissue sarcoma.

Symptoms and treatment depend on the type of cancer and how advanced it is. Treatments may include:

• Surgery
• Radiation therapy
• Chemotherapy
• Stem cell transplants
• Targeted therapy, which uses drugs or other substances that attack specific cancer cells with less harm to normal cells

NIH: National Cancer Institute