Neuroblastoma Is the Most Common Cancer Found in Infants. It Is Rarely Found in Children

Neuroblastoma is the most common cancer found in infants. It is rarely found in children older than ten. This form of cancer forms in developing nerve cells of an embryo or fetus. (The term ‘neuro’ means nerves, and the ‘blastoma’ is a cancer in developing cells.) Neuroblastoma is a solid tumor cancer that forms in the nervous system, which is the brain, spinal cord, and all the nerves that travel throughout the body. The sympathetic nervous system, which is the part affected by neuroblastoma, consists of the nerve fibers that span the length of the spinal cord, clusters of nerve cells called ganglea found along the path of the nerve fibers, and nerve-like cells found in the adrenal glands of the kidneys. Neuroblastomas form in these cells, so they can be found anywhere throughout these paths. The majority are found in the abdomen, with the rest occurring in the chest, neck, pelvis or other locations.

Neuroblastoma occurs with different degrees of gravity and aggression, labeled low-, intermediate-, and high-risk. Children diagnosed with the low-risk variety usually require surgery alone and recover remarkably well. Intermediate-risk patients are treated with moderate doses of chemotherapy. Survival rates for these two groups are over 95 percent. Blindness can occur if the cancer has metastasized. This form of cancer often metastasizes to the bone marrow, bone, liver, lymph nodes, and less commonly the skin or the brain. About 50% of children with neuroblastoma will have high-risk disease, which often returns or becomes resistant to standard therapies. These patients often develop secondary cancers. Treatment includes chemotherapy, stem cell transplantation and radiation therapy.

Neuroblastoma can have different effects on the eye. If metastasized, this cancer often affects the orbit, the bony socket that protects the eyeball. When this occurs, proptosis (a protrusion or bulging forward of the eyeball) is often a physical result. Also there can be bruising of the eye tissue, known as periorbital ecchymosis. This is a bleeding of the tissues resulting in discoloration of the skin. Other physical signs are opsoclonus, a series of jerky or erratic movements of both eyes (usually horizontally) and Horner’s syndrome, caused by damage to the sympathetic nerves often on just one side of the head. This syndrome can bring about miosis (constricted pupils), ptosis (droopy eyelid) and anhydrosis (reduced facial sweating).

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