title: Stage 4S neuroblastoma, a disseminated tumor with excellent outcome.
abstract: OBJECTIVE
  To review the clinical features and outcome of all cases of stage 4S neuroblastoma treated at our center.
  
  
  METHODS
  We retrospectively reviewed the files of all patients (n=75) with neuroblastoma treated at King Abdul-Aziz Medical City, Jeddah, Kingdom of Saudi Arabia between 1986 and 2005. We studied the clinical features and outcome of patients with stage 4S neuroblastoma.
  
  
  RESULTS
  Six patients (8%) were confirmed to have stage 4S neuroblastoma. Three were boys with a median age at diagnosis of 4.5 months (range 28 days-11 months). Four patients required no intervention. The remaining 2 patients were treated with chemotherapy due to progressive hepatomegaly and respiratory distress. No patient required radiotherapy or surgical intervention. With a median follow up of 4 years (range 9 months-15.5 years), all patients are alive and well. Two patients continue to have a residual abdominal mass, while complete resolution occurred in the others.
  
  
  CONCLUSIONS
  Stage 4S neuroblastoma is a special tumor that carries excellent prognosis. Spontaneous regression may occur and intervention is only required in symptomatic patients.
authors.affiliation: Pediatric Oncology/Hematology Section, Princess Noorah Oncology Center, King Abdul-Aziz Medical City, Jeddah, Kingdom of Saudi Arabia.
authors.forename: Najla A
authors.initials: NA
authors.lastname: Elimam
authors.forename: Ayad A
authors.initials: AA
authors.lastname: Atra
authors.forename: Najwa Y
authors.initials: NY
authors.lastname: Fayea
authors.forename: Tareq G
authors.initials: TG
authors.lastname: Al-Asaad
authors.forename: Taha M
authors.initials: TM
authors.lastname: Khattab
authors.forename: Ganadeel A
authors.initials: GA
authors.lastname: Al-Sulami
authors.forename: Sami K
authors.initials: SK
authors.lastname: Felimban
mesh_terms: D000310:Adrenal Gland Neoplasms / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000473:pathology; D000311:Adrenal Glands / Q000473:pathology; D000367:Age Factors; D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000627:therapeutic use; D018906:Antineoplastic Agents, Alkylating / Q000008:administration & dosage / Q000627:therapeutic use; D000972:Antineoplastic Agents, Phytogenic / Q000008:administration & dosage / Q000627:therapeutic use; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001706:Biopsy; D016190:Carboplatin / Q000008:administration & dosage / Q000627:therapeutic use; D003520:Cyclophosphamide / Q000008:administration & dosage / Q000627:therapeutic use; D004317:Doxorubicin / Q000627:therapeutic use; D005047:Etoposide / Q000008:administration & dosage / Q000627:therapeutic use; D005260:Female; D005500:Follow-Up Studies; D006529:Hepatomegaly / Q000175:diagnosis / Q000209:etiology; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008113:Liver Neoplasms / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000473:pathology; D008297:Male; D009365:Neoplasm Regression, Spontaneous; D009367:Neoplasm Staging; D009447:Neuroblastoma / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000401:mortality / Q000473:pathology / Q000556:secondary; D011379:Prognosis; D012189:Retrospective Studies; D012529:Saudi Arabia; D012867:Skin / Q000473:pathology; D012878:Skin Neoplasms / Q000175:diagnosis / Q000473:pathology / Q000556:secondary; D016019:Survival Analysis; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014750:Vincristine / Q000008:administration & dosage / Q000627:therapeutic use
chemical_list: D000970:Antineoplastic Agents; D018906:Antineoplastic Agents, Alkylating; D000972:Antineoplastic Agents, Phytogenic; D014750:Vincristine; D005047:Etoposide; D004317:Doxorubicin; D003520:Cyclophosphamide; D016190:Carboplatin