title: Different Kinds of Paraneoplastic Syndromes in Childhood Neuroblastoma.
abstract: BACKGROUND
  Clinical presentations of paraneoplastic syndromes in neuroblastoma may multiply. Review of the clinical data and the literature on this syndrome may help in the diagnosis of neuroblastoma.
  
  
  OBJECTIVE
  In order to make more accurate diagnosis, we reviewed the clinical data and the literature on this syndrome.
  
  
  METHODS
  Between April 2007 and April 2012, 68 children were diagnosed with neuroblastoma or ganglioneuroblastoma in our institution, 9 of which presented exclusively with paraneoplastic syndromes and were not treated with chemotherapy prior to diagnosis. After the diagnosis, all patients received chemotherapy and operation on NB97 protocol.
  
  
  RESULTS
  Among 68 pediatric patients with neuroblastoma or ganglioneuroblastoma, 4 (5.9%) patients suffered from neurological complications at diagnosis, 2 (2.9%) patients had digestive tract disorders, 2 (2.9%) patients had immune diseases, and 1 (1.5%) suffered from hematological disorder (without bone marrow involvement). All paraneoplastic syndrome patients achieved complete remission on paraneoplastic syndrome before completion of chemotherapy.
  
  
  CONCLUSIONS
  Neuroblastoma may present with a range of non-specific neurologic symptoms in addition to the well-known opsoclonus-myoclonus syndrome and cerebellar ataxia. In any case, the presence of unexplained neurologic manifestations and other common clinical presentations such as rash, constipation, diarrhea, and especially immune disorders in an otherwise healthy child had raised the possibility of paraneoplastic syndrome due to the presence of an undiagnosed tumor.
authors.affiliation: Department of Pediatric Hematology and Oncology, First Hospital of Jilin University, Changchun, China.
authors.forename: Yu-Tong
authors.initials: YT
authors.lastname: Zhang
authors.affiliation: Department of Obstetrics and Gynecology, First Hospital of Jilin University, Changchun, China.
authors.forename: Li-Hua
authors.initials: LH
authors.lastname: Feng
authors.affiliation: Department of Pediatric Intensive Care Unit, First Hospital of Jilin University, Changchun, China.
authors.forename: Zhen
authors.initials: Z
authors.lastname: Zhang
authors.affiliation: Department of Pediatric Hematology and Oncology, First Hospital of Jilin University, Changchun, China.
authors.forename: Xiao-Dan
authors.initials: XD
authors.lastname: Zhong
authors.affiliation: Department of Pediatric Hematology and Oncology, First Hospital of Jilin University, Changchun, China.
authors.forename: Jian
authors.initials: J
authors.lastname: Chang
keywords: Child; Ganglioneuroblastoma; Nervous System Diseases; Neuroblastoma; Paraneoplastic Syndromes