CT further demonstrates calcifications of the tumor and determines the exact position in relation to other intra-abdominal and retroperitoneal organs. It also reveals any intraspinal or intracranial extension of the tumor or its metastases. MRI demonstrates bone marrow metastases with great accuracy. Plain radiographs or isotope bone scans can be used to detect bony cortical lesions. A 24-hr urine collection to determine levels of homovallinic acid, vanillylmandelic acid, adrenaline, noradrenaline, DOPA, and metanephric, aids in the assessment of the patient.
Surgical resection is the primary treatment of localized neuroblastoma.
Adjuvant chemotherapy and radiotherapy are added, depending on the stage of the disease and the age of the patient. If the tumor is considered unresectable, a diagnostic open biopsy or a needle biopsy is performed. Bone marrow may also demonstrate classic small round cells forming rosettes. To control the disease, the child may be given chemotherapy and radiotherapy prior to attempted resection. In some, high-dose chemotherapy is followed by bone marrow transplantation.