title: Successful treatment of MYCN amplified, progressive stage 4S neuroblastoma in a neonate with hepatic artery embolization in addition to multimodality treatment.
abstract: 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.
authors.affiliation: Department of Oncology, Great Ormond Street Hospital for Children NHS Trust, Great Ormond Street, London, United Kingdom.
authors.forename: Kaan
authors.initials: K
authors.lastname: Boztug
authors.forename: Edward
authors.initials: E
authors.lastname: Kiely
authors.forename: Derek J
authors.initials: DJ
authors.lastname: Roebuck
authors.forename: Mark
authors.initials: M
authors.lastname: Gaze
authors.forename: Joanna
authors.initials: J
authors.lastname: Begent
authors.forename: Penelope
authors.initials: P
authors.lastname: Brock
authors.forename: Antony
authors.initials: A
authors.lastname: Michalski
mesh_terms: 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
chemical_list: C459801:MYCN protein, human; D000071447:N-Myc Proto-Oncogene Protein; D009687:Nuclear Proteins; D015513:Oncogene Proteins