title: Multidisciplinary management of cervical neuroblastoma in infants.
abstract: OBJECTIVE
  Neuroblastoma is the most common malignancy in infancy, it is a histologically and genetically heterogeneous tumor, the therapy and outcome of which is influenced by age, histological variant and genetic background as well.
  
  
  METHODS
  We present two consecutive infant patients with neuroblastoma of the neck discussing the etiology, the diagnosis and the surgical and oncological treatment of the tumor, which was observed in a relatively rare manifestation in the head-neck region.
  
  
  RESULTS
  Our first patient (age: 5.5 months) was MYCN (v-myc myelocytomatosis viral related oncogene, neuroblastoma derived) negative, INSS (International Neuroblastoma Staging System) Stage 3 and INRGSS (International Neuroblastoma Risk Group Staging System) Stage 3 because of the contralateral lymph node involvement while the complete gross resection of the primary tumor mass was feasible. The patient is tumor free after three years of follow-up. Our second patient (age: 5 months) was MYCN negative, INSS Stage 2 and INRGSS Stage 1, as both the primary tumor and the ipsilateral lymph nodes were totally removed via a modified radical neck dissection. The patient is tumor free after three years of follow-up.
  
  
  CONCLUSIONS
  For MYCN negative patients, especially in early age, the prognosis of neuroblastoma is good, surgical resection and chemotherapy together is an adequate treatment protocol (as in our two patients). While MYCN-amplified patients require a combined and aggressive treatment with surgery, chemotherapy, radiotherapy, and immunotherapy to be able to obtain a favorable survival rate according to the literature.
authors.affiliation: Department of Otorhinolaryngology and Head and Neck Surgery, University of Szeged, Hungary. Electronic address: mcsanady@freemail.hu.
authors.forename: Miklós
authors.initials: M
authors.lastname: Csanády
authors.affiliation: Department of Otorhinolaryngology and Head and Neck Surgery, University of Szeged, Hungary.
authors.forename: Gábor
authors.initials: G
authors.lastname: Vass
authors.affiliation: Department of Pediatrics, University of Szeged, Hungary.
authors.forename: Katalin
authors.initials: K
authors.lastname: Bartyik
authors.affiliation: Department of Anaesthesiology and Intensive Therapy, University of Szeged, Hungary.
authors.forename: Valéria
authors.initials: V
authors.lastname: Majoros
authors.affiliation: Department of Otorhinolaryngology and Head and Neck Surgery, University of Szeged, Hungary.
authors.forename: László
authors.initials: L
authors.lastname: Rovó
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D017024:Chemotherapy, Adjuvant; D003609:Dactinomycin / Q000627:therapeutic use; D018572:Disease-Free Survival; D005260:Female; D006258:Head and Neck Neoplasms / Q000473:pathology / Q000628:therapy*; D006801:Humans; D007223:Infant; D008207:Lymphatic Metastasis; D037981:Neck Dissection; D009447:Neuroblastoma / Q000473:pathology / Q000628:therapy*; D010348:Patient Care Team; D014750:Vincristine / Q000627:therapeutic use
chemical_list: D003609:Dactinomycin; D014750:Vincristine
keywords: Combined therapy; Infants; MYCN negativity; Neuroblastoma