A focal lesion in the falx cerebri: Harbinger of classic stage 4 neuroblastoma in an infant cured despite residual disease after minimal therapy.
An asymptomatic 11-week-old male received no treatment after he was classified as having a suspected atypical form of MYCN-nonamplified hyperdiploid stage 4S neuroblastoma (NB), with masses in an adrenal gland, subcutaneous tissues, and the falx cerebri. Within 2 months, however, disease progressed in dura and bone marrow. Two cycles of low-dose chemotherapy achieved a partial response; treatment was discontinued. Complete remission was documented 24 weeks post-cycle 2, and has continued >6 years. The falx cerebri probably does not represent an atypical site for stage 4S NB, but stage 4 NB with favorable biology is sometimes curable with minimal therapy.
Kushner
Brian H
BH
Department of Pediatrics, Memorial Sloan-Kettering Cancer Center, New York, New York 10065, USA. kushnerb@mskcc.org
Kramer
Kim
K
Modak
Shakeel
S
Akhurst
Timothy J
TJ
Cheung
Nai-Kong V
NK
D019797:3-Iodobenzylguanidine; D000310:Adrenal Gland Neoplasms / Q000188:drug therapy / Q000235:genetics / Q000473:pathology*; D000782:Aneuploidy; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001853:Bone Marrow / Q000000981:diagnostic imaging / Q000473:pathology; D016190:Carboplatin / Q000008:administration & dosage; D003520:Cyclophosphamide / Q000008:administration & dosage; D018572:Disease-Free Survival; D004317:Doxorubicin / Q000008:administration & dosage; D004388:Dura Mater / Q000000981:diagnostic imaging / Q000473:pathology*; D005047:Etoposide / Q000008:administration & dosage; D005269:Femur / Q000000981:diagnostic imaging / Q000473:pathology; D006801:Humans; D007223:Infant; D007457:Iodine Radioisotopes; D008297:Male; D008577:Meningeal Neoplasms / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000556:secondary*; D009367:Neoplasm Staging; D018365:Neoplasm, Residual; D009447:Neuroblastoma / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000235:genetics / Q000473:pathology / Q000556:secondary*; D011877:Radionuclide Imaging; D012074:Remission Induction; D012878:Skin Neoplasms / Q000188:drug therapy / Q000556:secondary
D007457:Iodine Radioisotopes; D019797:3-Iodobenzylguanidine; D005047:Etoposide; D004317:Doxorubicin; D003520:Cyclophosphamide; D016190:Carboplatin