Frozen section of an adjacent lymph node revealed the diagnosis of neuroblastoma. The superior and posterior aspects of the mass were released from branches of the sympathetic chain and the mass was completely removed. Further workup, including bone marrow biopsy, chest CT, and abdominal CT, was negative. No further adjuvant therapy was given. Neuroblastoma is the most common solid tumor in children under age six years.
Cervical disease is usually the result of metastasis.
These patients may present with Horner's syndrome and heterochromia. Neuroblastomas are APUDomas derived from embryonic neural crest cells. They secrete catecholamines and VMA, a urinary metabolite, that may be a useful marker in diagnosis. Therapy for primary cervical neuroblastoma differs from other sites in that surgery alone results in a very high cure rate. Recent studies suggest that additional chemotherapy and radiation therapy do not improve survival.