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Neuroblastoma in children is a solid tumor or cancer that occurs in the developing cells of the sympathetic nervous system, which aids in the control of the body’s internal organs. The cells that make up neuroblastoma tumors are called neuroblasts. The majority of neuroblastoma tumors in children (65%) begin in the adrenal glands, which are located on top of each kidney. However, tumors can begin anywhere in the body. Other common sites for neuroblastoma are the chest, neck and pelvis. While neuroblastoma may be found in only one spot in the body at the time of diagnosis in some patients, in others this cancer may have spread (metastasized) from its primary location to the lymph nodes, bone marrow or bones.
Many researchers believe that neuroblastoma develops when normal neuroblasts (the immature cells of the sympathetic nervous system) fail to mature into normal nerve cells. Instead, the neuroblasts grow and divide without the usual controls, leading to the growth of a cancerous mass of cells, also called a tumor.
There are many procedures and tests that might be done to see if and where cancer cells are present in the body. The exact combination of testing that will be used to diagnose a child is dependent upon the symptoms that are present and the suspected type of cancer.
Understanding the risk for relapse is important because there are large differences between the treatments for low-risk, intermediate-risk and high-risk disease. In general, high-risk neuroblastomas are more likely to come back and therefore require stronger treatment than low- or intermediate-risk disease. Stronger treatment selected for high-risk disease has been shown to benefit patients; however, it also has more side effects. Therefore, risk assessment is an essential step in determining appropriate treatment.
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