This cancer arises from widely diverse locations and demonstrates an usually broad pattern of clinical presentations. The average age approaches 2 years and it is slightly more common in boys. Limited therapy is curative in localized disease.
Most children present with a mass in the head and neck, chest, abdomen or pelvis.
When the tumor is in the abdomen it may cause generalized discomfort, abdominal distention, and back pain as well as neurologic symptoms. The first successful removal of a neuroblastoma was reported in 1916. However, it has become increasingly clear that intensive multi-modality treatment is necessary for favorable outcomes in the advanced forms of the disease, which generally affect about half the children. Since accurate disease staging is essential for planning appropriate treatment a multinational multidisciplinary forum developed the International Neuroblastoma Staging System in 1993. Surgical expertise was important in implementing this system from the standpoint of initial diagnosis, operative therapy, assessment of response, and detection of recurrent disease.