Neuroblastoma : Clinical Features - I

Most children present with abdominal pain or a palpable abdominal mass noted by a parent while bathing or dressing the child. Others present with manifestations related to the tumor mass and metastases which include: proptosis and periorbital ecchymosis ( so-called raccoon or panda eyes; from retrobulbar metastases), bone pain (from skeletal metastases), pancytopenia (massive bone marrow metastases), paralysis (intraspinal spread with spinal cord compression; so-called dumbbell lesion), watery diarrhea (due to secretion of vasoactive intestinal peptide by the tumor), and urinary retention and constipation (due to extrinsic compression of bladder and bowel by the tumor). The image shows a pink-tan, lobulated, soft, fleshy neuroblastoma. The right edge of the tumor has hemorrhagic foci and punctate calcifications. Image courtesy of Dr. Jean-Christophe Fournet, Paris, France; humpath.com; Used with permission