It is of embryonic origin, arising from primitive sympathetic system cells derived from the neural crest. The incidence of neuroblastoma is approximately 1 in 10,000 children and is more common in boys than in girls. Neuroblastoma usually presents with an abdominal mass or abdominal discomfort. Catecholamine production by the tumor can occasionally result in flushing, sweating, and irritability, while vasoactive intestinal polypeptides, also produced by the tumor, may rarely cause watery, explosive secretory diarrhea. Many patients have metastases at diagnosis, mainly to regional and distant lymph nodes, bone marrow, bone cortex, liver, and occasionally lungs.
Symptoms related to metastases include bone pain and anemia.
Neuroblastoma presents as a solid, often fixed and painful mass crossing the midline. Its position does not change with respiration. The purpose of the diagnostic studies is to find the exact location and size of the tumor and to determine regional invasion, metastatic disease, and histology. Ultrasonography distinguishes a solid mass from a cystic mass and determines its position in relation to the kidney. CT further demonstrates calcifications of the tumor and determines the exact position in relation to other intra-abdominal and retroperitoneal organs.