Symptoms and causes

Symptoms

Signs and symptoms of neuroblastoma vary depending on what part of the body is affected.

Neuroblastoma in the abdomen — the most common form — may cause signs and symptoms such as:

  • Abdominal pain
  • A mass under the skin that isn't tender when touched
  • Changes in bowel habits, such as diarrhea or constipation

Neuroblastoma in the chest may cause signs and symptoms such as:

  • Wheezing
  • Chest pain
  • Changes to the eyes, including drooping eyelids and unequal pupil size

Other signs and symptoms that may indicate neuroblastoma include:

  • Lumps of tissue under the skin
  • Eyeballs that seem to protrude from the sockets (proptosis)
  • Dark circles, similar to bruises, around the eyes
  • Back pain
  • Fever
  • Unexplained weight loss
  • Bone pain

When to see a doctor

Contact your child's doctor if your child has any signs or symptoms that worry you. Mention any changes in your child's behavior or habits.

Causes

In general, cancer begins with a genetic mutation that allows normal, healthy cells to continue growing without responding to the signals to stop, which normal cells do. Cancer cells grow and multiply out of control. The accumulating abnormal cells form a mass (tumor).

Neuroblastoma begins in neuroblasts — immature nerve cells that a fetus makes as part of its development process.

As the fetus matures, neuroblasts eventually turn into nerve cells and fibers and the cells that make up the adrenal glands. Most neuroblasts mature by birth, though a small number of immature neuroblasts can be found in newborns. In most cases, these neuroblasts mature or disappear. Others, however, form a tumor — a neuroblastoma.

It isn't clear what causes the initial genetic mutation that leads to neuroblastoma.

Risk factors

Children with a family history of neuroblastoma may be more likely to develop the disease. Yet, familial neuroblastoma is thought to comprise a very small number of neuroblastoma cases. In most cases of neuroblastoma, a cause is never identified.

Complications

  • Spread of the cancer (metastasis). Neuroblastoma may spread (metastasize) to other parts of the body, such as the lymph nodes, bone marrow, liver, skin and bones.
  • Spinal cord compression. Tumors may grow and press on the spinal cord, causing spinal cord compression. Spinal cord compression may cause pain and paralysis.
  • Signs and symptoms caused by tumor secretions. Neuroblastoma cells may secrete certain chemicals that irritate other normal tissues, causing signs and symptoms called paraneoplastic syndromes. One paraneoplastic syndrome that occurs rarely in people with neuroblastoma causes rapid eye movements and difficulty with coordination. Another rare syndrome causes abdominal swelling and diarrhea.
Dec. 04, 2015
References
  1. Kliegman RM, et al. Neuroblastoma. In: Nelson Textbook of Pediatrics. 20th ed. Philadelphia, Pa.: Elsevier; 2016. http://www.clinicalkey.com. Accessed Nov. 3, 2015.
  2. Irwin MS, et al. Neuroblastoma: Paradigm for precision medicine. Pediatric Clinics of North America. 2015;62:225.
  3. Niederhuber JE, et al., eds. Pediatric solid tumors. In: Abeloff's Clinical Oncology. 5th ed. Philadelphia, Pa.: Churchill Livingstone Elsevier; 2014. http://www.clinicalkey.com. Accessed Nov. 3, 2015.
  4. Neuroblastoma treatment (PDQ). National Cancer Institute. http://www.cancer.gov/types/neuroblastoma/patient/neuroblastoma-treatment-pdq. Accessed Nov. 3, 2015.
  5. Wilson JS, et al. A systematic review of 131I-meta iodobenzylguanidine molecular radiotherapy for neuroblastoma. European Journal of Cancer. 2014;50:801.
  6. Radiation therapy for neuroblastoma. American Cancer Society. http://www.cancer.org/cancer/neuroblastoma/detailedguide/neuroblastoma-treating-radiation-therapy. Accessed Nov. 11, 2015.