title: Is aggressive local treatment necessary for diffuse liver involvement in patients with progression of stage 4s neuroblastoma to stage 4?
abstract: Three patients with stage 4S neuroblastoma without MYC-N amplification who progressed to stage 4 with persistent liver involvement, were treated with iodine 131-meta-iodobenzylguanidine therapy, chemotherapy, and surgery. Successive histologic examination of the liver showed differentiation of the tumor in 2 patients and fibrosis in the third. One patient died of brain metastases at the age of 30 months. The other 2 patients are alive at 50 and 44 months. Diffuse liver involvement in patients with stage 4 progression of previous stage 4S without MYC-N amplification may differentiate after treatment. The aim of this report is to draw attention to major liver surgery that it may not be necessary in tumors without MYC-N amplification, despite the persistence of lesions in the liver.
authors.affiliation: Pediatric Surgical Center of Amsterdam (Emma Children's Hospital AMC and VU University Medical Center), PO Box 22660, 1100 DD Amsterdam, The Netherlands.
authors.forename: Hugo A
authors.initials: HA
authors.lastname: Heij
authors.forename: Arnauld C
authors.initials: AC
authors.lastname: Verschuur
authors.forename: Gert-Jan L
authors.initials: GJ
authors.lastname: Kaspers
authors.forename: Rick R
authors.initials: RR
authors.lastname: van Rijn
authors.forename: Judit A
authors.initials: JA
authors.lastname: Adam
authors.forename: Daniel C
authors.initials: DC
authors.lastname: Aronson
mesh_terms: D000310:Adrenal Gland Neoplasms / Q000473:pathology*; D018450:Disease Progression; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D007223:Infant; D008113:Liver Neoplasms / Q000556:secondary* / Q000628:therapy*; D008297:Male; D009367:Neoplasm Staging; D009447:Neuroblastoma / Q000473:pathology / Q000556:secondary* / Q000628:therapy*