Neuroblastoma in Adolescents and Children Older than 10 Years: Unusual Clinicopathologic and Biologic Features
| Autor: | Katherine M Chastain, Terrie G Flatt, Atif A. Ahmed, John Herriges, Linda D. Cooley, Eugenio Taboada, Robert E. Garola, Laura C. McCarthy |
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| Rok vydání: | 2019 |
| Předmět: |
Male
Pediatrics medicine.medical_specialty Adolescent MEDLINE Antineoplastic Agents 03 medical and health sciences Neuroblastoma 0302 clinical medicine Medicine Humans Neoplasm Metastasis Child Neoplasm Staging business.industry Hematology medicine.disease Prognosis Neoplasm Proteins Clinical trial Oncology 030220 oncology & carcinogenesis Pediatrics Perinatology and Child Health Neoplasm staging Female business 030215 immunology |
| Zdroj: | Journal of pediatric hematology/oncology. 41(8) |
| ISSN: | 1536-3678 |
| Popis: | Neuroblastoma (NB) in children older than 10 years is rare. We reviewed our archives for patients with NB aged 10 to 18 years and summarized their clinicopathologic/genetic records. Of 96 patients, 4 patients were identified in this age group. Four tumors were abdominal; 1 patient had 2 tumors at diagnosis, one of which was presacral. Tumor sizes ranged from 3 to 20 cm. All tumors were high risk at clinical stages 3 and 4, with metastasis to bone marrow and other areas. Four tumors were poorly differentiated with unfavorable histology and one patient with bilateral adrenal disease had an intermixed ganglioneuroblastoma on one side. Another tumor exhibited pheochromocytoma-like morphology. MYCN amplification was present in bone marrow metastasis in one case. Complex chromosomal gains and 19p deletions were common. Exome sequencing revealed ALK variants in 2 cases and previously unreported MAGI2, RUNX1, and MLL mutations. All patients received standard chemotherapy and 2 patients received ALK-targeted trial therapy. Three patients died of disease, ranging 18 to 23 months after diagnosis. One patient has active disease and is receiving trial therapy. In conclusion, NB in children older than 10 years may exhibit unusual clinicopathologic and genetic features with large tumors, bilateral adrenal disease, rare morphologic features, complex DNA microarray findings and novel mutations. Patients often have grim prognoses despite genomic profiling-guided targeted therapy. |
| Databáze: | OpenAIRE |
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