Successful treatment of MYCN amplified, progressive stage 4S neuroblastoma in a neonate with hepatic artery embolization in addition to multimodality treatment.
Stage 4S metastatic neuroblastoma (NB) has a favorable prognosis due to a high rate of spontaneous regression. Young infants risk lethal complications arising from hepatomegaly, which can develop rapidly despite treatment. MYCN oncogene amplification confers a significantly worse prognosis. We describe a 4-week-old neonate with MYCN-amplified stage 4S NB complicated by gross hepatomegaly causing rapidly progressive respiratory, hepatic, and renal failure. The child remains in remission 3 years after hepatic artery embolization, radiotherapy, standard, and high-dose chemotherapy. Embolization of the hepatic artery, with classical treatment, is feasible and safe at this age and may contribute substantially to the management of high-risk patients.
Boztug
Kaan
K
Department of Oncology, Great Ormond Street Hospital for Children NHS Trust, Great Ormond Street, London, United Kingdom.
Kiely
Edward
E
Roebuck
Derek J
DJ
Gaze
Mark
M
Begent
Joanna
J
Brock
Penelope
P
Michalski
Antony
A
D003131:Combined Modality Therapy; D004621:Embolization, Therapeutic; D005784:Gene Amplification; D006499:Hepatic Artery / Q000000981:diagnostic imaging; D006529:Hepatomegaly / Q000000981:diagnostic imaging / Q000235:genetics / Q000628:therapy; D006801:Humans; D007231:Infant, Newborn; D000071447:N-Myc Proto-Oncogene Protein; D009447:Neuroblastoma / Q000000981:diagnostic imaging / Q000235:genetics / Q000628:therapy*; D009687:Nuclear Proteins / Q000235:genetics*; D015513:Oncogene Proteins / Q000235:genetics*; D011859:Radiography
C459801:MYCN protein, human; D000071447:N-Myc Proto-Oncogene Protein; D009687:Nuclear Proteins; D015513:Oncogene Proteins