Neuroblastoma

About neuroblastoma

Neuroblastomas are masses of early nerve cells (called neuroblasts) that have grown out of control. This type of cancer occurs most often in infants and young children. The types of cancer that develop in children are often different from the types that develop in adults. To learn more, see Childhood Cancer.

Neuroblastomas are cancers that start in early nerve cells of the sympathetic nervous system, so they can be found anywhere along this system. Most neuroblastomas begin in the abdomen (belly), either in an adrenal gland or in sympathetic nerve ganglia. Most of the rest start in sympathetic ganglia near the spine in the chest or neck, or in the pelvis.

Some neuroblastomas grow and spread quickly, while others grow slowly. Sometimes, in very young children, the tumor goes away on its own. In other cases, the cells sometimes mature into normal cells and stop dividing, which makes the tumor a benign ganglioneuroma (see below).

Understanding the sympathetic nervous system

The sympathetic nerves control key body functions like our heart rate, breathing, blood pressure, digestion, and other functions. It includes:

• Nerve fibers that run along both sides of the spinal cord.
• Clusters of nerve cells called ganglia (plural of ganglion) at certain points along the path of the nerve fibers.
• Nerve-like cells found in the center of the adrenal glands—small glands that sit on top of each kidney. These glands make hormones that help control heart rate, blood pressure, blood sugar, and how the body reacts to stress.

Other autonomic nervous system tumors in children

Not all childhood autonomic nervous system tumors are malignant (cancerous). Some tumors are benign (non-cancerous), and some can have both benign and cancer cells within the same tumor.

• Ganglioneuroma is a benign (non-cancerous) tumor made up of mature ganglion and nerve sheath cells.
• Ganglioneuroblastoma is a tumor that has both malignant and benign parts. It contains neuroblasts (immature nerve cells) that can grow and spread abnormally, similar to neuroblastoma, as well as areas of more mature tissue that are similar to ganglioneuroma.

If a child is thought to have one of these tumors, it is usually removed by surgery and looked at carefully with a microscope to see if it has areas of cancer cells (which would make it a ganglioneuroblastoma). If the final diagnosis is ganglioneuroma, no other treatment may be needed. If it is found to be ganglioneuroblastoma, it may be treated more like neuroblastoma depending on factors like the extent of the disease and how aggressive the tumor looks under the microscope.