Maturation of mass-screened localized adrenal neuroblastoma.
OBJECTIVE
In infants, neuroblastoma has been known to spontaneously differentiate into a benign ganglioneuroma. Although several investigators have compared mass-screened with unscreened, disseminated with localized, and adrenal with retroperitoneal neuroblastoma, there are very few cross-comparisons of the above parameters. Herein, the authors report the maturation of mass-screened, localized adrenal neuroblastoma.


METHODS
Fifty-one mass-screened adrenal neuroblastomas were divided into 2 groups. In infants less than 1 year of age (Group A), 45 neuroblastomas were resected, whereas 6 neuroblastomas were resected after observation in 1- to 4-year-old children (group B). Histopathology of the tumors in the 2 groups was compared. Data were analyzed by X(2) test, and P <.05 was considered significant.


RESULTS
According to the International Neuroblastoma Pathological Classification, 41 of 45 tumors of group A were "differentiating neuroblastoma" and 4 of 6 tumors of group B were "maturing ganglioneuroma." Maturation toward ganglioneuroblastoma was observed in 16 neuroblastomas of group A (36%) and 6 neuroblastomas of group B (100%). In group A, 58% had low mitosis karyorrhexis index (MKI); all patients in group B had low MKI.


CONCLUSIONS
If left untreated, maturation of mass-screened, localized adrenal neuroblastomas is a common phenomenon. These children do not need to undergo early operation.
Iwanaka
T
T
Department of Surgery, Saitama Children's Medical Center, 2100 Magome, Iwatsuki, Saitama 339-8551, Japan.
Yamamoto
K
K
Ogawa
Y
Y
Arai
M
M
Ito
M
M
Kishimoto
H
H
Hanada
R
R
Imaizumi
S
S
D000310:Adrenal Gland Neoplasms / Q000145:classification / Q000473:pathology*; D002648:Child; D002675:Child, Preschool; D005729:Ganglioneuroma / Q000145:classification / Q000473:pathology*; D006801:Humans; D007223:Infant; D008403:Mass Screening; D009365:Neoplasm Regression, Spontaneous; D009367:Neoplasm Staging; D009447:Neuroblastoma / Q000145:classification / Q000473:pathology*