Dumbbell neuroblastoma presenting without spinal cord findings.
Patients with dumbbell neuroblastoma present with a wide variety of spinal cord problems. We recently treated an infant with a large dumbbell neuroblastoma who was neurologically intact. Because a CAT scan showed a retroperitoneal mass to be abutting the right vertebral body at T12-L1, a precautionary myelogram was performed, which revealed extensive intraspinal extension. We report this case to emphasize the need to have a high index of suspicion of spinal cord involvement in light of a normal neurologic examination since, any attempt at removing the extraspinal part, first, could cause serious neurologic sequelae. We also wish to emphasize avoiding radiation therapy when the tumor has been removed grossly to lessen the development of kyphoscoliatic deformity. The infant will be routinely followed with serial VMAs and ultrasound.
D006801:Humans; D007231:Infant, Newborn; D009447:Neuroblastoma / Q000000981:diagnostic imaging* / Q000601:surgery; D011859:Radiography; D012186:Retroperitoneal Neoplasms / Q000000981:diagnostic imaging* / Q000601:surgery; D013125:Spinal Neoplasms / Q000000981:diagnostic imaging* / Q000601:surgery