Bilateral adrenal neuroblastoma: peculiar pattern of a rare pediatric presentation.

BSN Bilateral Multifocal Neuroblastoma Suprarenal

Journal

Discover. Oncology
ISSN: 2730-6011
Titre abrégé: Discov Oncol
Pays: United States
ID NLM: 101775142

Informations de publication

Date de publication:
12 Apr 2024
Historique:
received: 06 11 2023
accepted: 02 04 2024
medline: 12 4 2024
pubmed: 12 4 2024
entrez: 12 4 2024
Statut: epublish

Résumé

Bilateral suprarenal neuroblastoma (BSN) is a rare presentation. Few previously published literature showed BSN patients to have favorable pattern and prognosis. This study aim was to evaluate clinical and biological features in relation to outcome of Egyptian patients with BSN. Included patients were diagnosed from 2007 to 2017, retrospectively. Tissue biopsy, imaging and bone marrow were evaluated at presentation. Clinical, demographic, biological variables and risk group were determined and analyzed in relation to overall (OS) and event-free-survival (EFS). BSN patients (n = 33) represented 2% of hospital patients with neuroblastoma during the 10-year study period, 17 were males and 16 were females. Twenty-four patients (72.7%) were infants, and 9 patients (27.3%) were above 1 year of age (range: 1 month to 3 years). Metachronous disease was present in only one patient. Amplified MYCN was found in 10 patients. Initially, most patients (n = 25) had distant metastasis, 6 had stage 3 versus 2 stage 2. Fifteen were high risk (HR), 15 intermediate (IR), 1 low risk (LR) and 2 were undetermined due to inadequate tissue biopsy. Three-year OS for HR and IR patients were 40.5% and 83.9% versus 23.2% and 56.6% EFS; respectively. BSN treatment is similar to unilateral disease. A more conservative surgical approach with adrenal tissue preservation on less extensive side should be considered. Biological variables and extent of disease are amongst the most important prognostic determinants. Future studies are warranted to further address the biologic profiling of BSN and highlight prognostic significance of size difference between both adrenal sides.

Sections du résumé

BACKGROUND BACKGROUND
Bilateral suprarenal neuroblastoma (BSN) is a rare presentation. Few previously published literature showed BSN patients to have favorable pattern and prognosis. This study aim was to evaluate clinical and biological features in relation to outcome of Egyptian patients with BSN.
METHODS METHODS
Included patients were diagnosed from 2007 to 2017, retrospectively. Tissue biopsy, imaging and bone marrow were evaluated at presentation. Clinical, demographic, biological variables and risk group were determined and analyzed in relation to overall (OS) and event-free-survival (EFS).
RESULTS RESULTS
BSN patients (n = 33) represented 2% of hospital patients with neuroblastoma during the 10-year study period, 17 were males and 16 were females. Twenty-four patients (72.7%) were infants, and 9 patients (27.3%) were above 1 year of age (range: 1 month to 3 years). Metachronous disease was present in only one patient. Amplified MYCN was found in 10 patients. Initially, most patients (n = 25) had distant metastasis, 6 had stage 3 versus 2 stage 2. Fifteen were high risk (HR), 15 intermediate (IR), 1 low risk (LR) and 2 were undetermined due to inadequate tissue biopsy. Three-year OS for HR and IR patients were 40.5% and 83.9% versus 23.2% and 56.6% EFS; respectively.
CONCLUSION CONCLUSIONS
BSN treatment is similar to unilateral disease. A more conservative surgical approach with adrenal tissue preservation on less extensive side should be considered. Biological variables and extent of disease are amongst the most important prognostic determinants. Future studies are warranted to further address the biologic profiling of BSN and highlight prognostic significance of size difference between both adrenal sides.

Identifiants

pubmed: 38607453
doi: 10.1007/s12672-024-00966-6
pii: 10.1007/s12672-024-00966-6
doi:

Types de publication

Journal Article

Langues

eng

Pagination

115

Informations de copyright

© 2024. The Author(s).

Références

Matthay KK, et al. Neuroblastoma. Nat Rev Dis Prim. 2016. https://doi.org/10.1038/nrdp.2016.78 .
doi: 10.1038/nrdp.2016.78 pubmed: 27830764
Pederiva F, Andres A, Sastre A, Alves J, Martinez L, Tovar JA. Bilateral adrenal neuroblastoma is different. Eur J Pediatr Surg. 2007;17(6):393–6. https://doi.org/10.1055/s-2007-965811 .
doi: 10.1055/s-2007-965811 pubmed: 18072022
Nickerson HJ, et al. Favorable biology and outcome of stage IV-S neuroblastoma with supportive care or minimal therapy: a Children’s Cancer Group study. J Clin Oncol. 2000;18(3):477–86. https://doi.org/10.1200/JCO.2000.18.3.477 .
doi: 10.1200/JCO.2000.18.3.477 pubmed: 10653863
Alymlahi E, Chellaoui M, Dafiri R. Bilateral adrenal neuroblastoma. Appl Radiol. 2009;38(6):38–9. https://doi.org/10.37549/ar1697 .
doi: 10.37549/ar1697
Johnston DL, Sweeney B, Halton JM. Bilateral adrenal neuroblastoma stage V disease. J Pediatr Hematol Oncol. 2007;29:652–5.
doi: 10.1097/MPH.0b013e318142b788 pubmed: 17805045
Pagès PM, et al. Bilateral adrenal neuroblastoma. Pediatr Blood Cancer. 2009;52(2):196–202. https://doi.org/10.1002/pbc.21765 .
doi: 10.1002/pbc.21765 pubmed: 18951434
Elzomor H, et al. Neuroblastoma-associated opsoclonous myoclonous ataxia syndrome: profile and outcome report on 15 Egyptian patients. J Pediatr Hematol Oncol. 2022;00(00):1–6. https://doi.org/10.1097/MPH.0000000000002466 .
doi: 10.1097/MPH.0000000000002466
Park JR, et al. Revisions to the international neuroblastoma response criteria: a consensus statement from the National Cancer Institute Clinical Trials Planning Meeting. J Clin Oncol. 2017;35(22):2580. https://doi.org/10.1200/JCO.2016.72.0177 .
doi: 10.1200/JCO.2016.72.0177 pubmed: 28471719 pmcid: 5676955
Peuchmaur M, et al. Revision of the international neuroblastoma pathology classification: confirmation of favorable and unfavorable prognostic subsets in ganglioneuroblastoma, nodular. Cancer. 2003;98(10):2274–81. https://doi.org/10.1002/CNCR.11773 .
doi: 10.1002/CNCR.11773 pubmed: 14601099
Shimada H, et al. The International neuroblastoma pathology classification (the Shimada system)-PubMed. Cancer. 1999;86(2):364–72.
doi: 10.1002/(SICI)1097-0142(19990715)86:2<364::AID-CNCR21>3.0.CO;2-7 pubmed: 10421273
Fawzy M, et al. Watch and see strategy in selected neuroblastoma case scenarios: success and limitations. J Pediatr Hematol Oncol. 2019;41(6):E384–7. https://doi.org/10.1097/MPH.0000000000001421 .
doi: 10.1097/MPH.0000000000001421 pubmed: 30676440
Irwin MS, et al. Revised neuroblastoma risk classification system: a report from the children’s oncology group. J Clin Oncol. 2021;39:3229–41.
doi: 10.1200/JCO.21.00278 pubmed: 34319759 pmcid: 8500606
Brodeur GM, et al. Revisions of the international criteria for neuroblastoma diagnosis, staging, and response to treatment. J Clin Oncol. 1993. https://doi.org/10.1200/JCO.1993.11.8.1466 .
doi: 10.1200/JCO.1993.11.8.1466 pubmed: 8336186
Bergeron C, et al. Long-term renal and hearing toxicity of carboplatin in infants treated for localized and unresectable neuroblastoma: results of the SFOP NBL90 study. Pediatr Blood Cancer. 2005;45(1):32–6. https://doi.org/10.1002/PBC.20379 .
doi: 10.1002/PBC.20379 pubmed: 15768383
Whittington HA, Hancock J, Kemshead JT. OPEC/OJEC for stage 4 neuroblastoma in children over 1 year of age. Med Pediatr Oncol. 2001;36(1):239–42. https://doi.org/10.1002/1096-911X(20010101)36:1%3c239::AID-MPO1058%3e3.0.CO;2-G .
doi: 10.1002/1096-911X(20010101)36:1<239::AID-MPO1058>3.0.CO;2-G
Kreissman SG, et al. Purged versus non-purged peripheral blood stem-cell transplantation for high-risk neuroblastoma (COG A3973): a randomised phase 3 trial. Lancet Oncol. 2014;14(10):999–1008. https://doi.org/10.1016/S1470-2045(13)70309-7.Purged .
doi: 10.1016/S1470-2045(13)70309-7.Purged
de Alarcon PA, et al. Intravenous immunoglobulin with prednisone and risk-adapted chemotherapy for children with opsoclonus myoclonus ataxia syndrome associated with neuroblastoma (ANBL00P3): a randomised, open-label, phase 3 trial. Lancet Child Adolesc Heal. 2018;2(1):25–34. https://doi.org/10.1016/S2352-4642(17)30130-X .
doi: 10.1016/S2352-4642(17)30130-X
Dinh T, Truong B, Matthay KK, Dubois SG. Comparison of clinical features and outcomes in patients with bilateral versus unilateral adrenal neuroblastoma. J Pediatr Hematol Oncol. 2017;39(2):108–13. https://doi.org/10.1097/MPH.0000000000000692 .
doi: 10.1097/MPH.0000000000000692 pubmed: 27820129
Mossé YP, et al. Identification of ALK as a major familial neuroblastoma predisposition gene. Nature. 2008;455(7215):930–5. https://doi.org/10.1038/nature07261 .
doi: 10.1038/nature07261 pubmed: 18724359 pmcid: 2672043
Rybinski B, et al. Multifocal primary neuroblastoma tumor heterogeneity in siblings with co-occurring PHOX2B and NF1 genetic aberrations. Genes Chromosomes Cancer. 2020;59(2):119–24. https://doi.org/10.1002/GCC.22809 .
doi: 10.1002/GCC.22809 pubmed: 31515834
Shaw H, Sabio A. Bilateral adrenal neuroblastoma. Am J Pediatr Hematol Oncol. 1984;6(1):3.
Lo Cunsolo C, Casciano I, Gambini C, De Bernardi B, Tonini GP, Romani M. Brief report: molecular alterations in a case of bilateral adrenal neuroblastoma. Med Pediatr Oncol. 2001. https://doi.org/10.1002/mpo.1115 .
doi: 10.1002/mpo.1115 pubmed: 11260574
Singha Roy P, Chhabra P, Jain R, Gupta P, Sodhi KS, Bansal D. Metastatic, Bilateral Adrenal Neuroblastoma Presenting With Blindness Without Proptosis. J Pediatr Hematol Oncol. 2021;43(8):e1250–2. https://doi.org/10.1097/MPH.0000000000002084 .
doi: 10.1097/MPH.0000000000002084 pubmed: 33512866
Fati F, Pulvirenti R, Paraboschi I, Martucciello G. Surgical approaches to neuroblastoma: review of the operative techniques. Child. 2021;8(6):446. https://doi.org/10.3390/CHILDREN8060446 .
doi: 10.3390/CHILDREN8060446
Chui CH, Chang KTE. The feasibility of adrenal-sparing surgery in bilateral adrenal neuroblastoma. J Pediatr Surg. 2020;55(12):2836–9. https://doi.org/10.1016/J.JPEDSURG.2020.06.038 .
doi: 10.1016/J.JPEDSURG.2020.06.038 pubmed: 32703624

Auteurs

Mohamed Fawzy (M)

Pediatric Oncology Department, Children's Cancer Hospital Egypt-57357, Cairo, Egypt.
National Cancer Institute, Cairo University, Cairo, Egypt.

Gehad Ahmed (G)

Faculty of Medicine, Department of General Surgery, Helwan University, Cairo, Egypt.
Surgical Oncology Department, Children's Cancer Hospital Egypt-57357, Cairo, Egypt.

Yasser Youssef (Y)

Pediatric Oncology Department, Children's Cancer Hospital Egypt-57357, Cairo, Egypt.
National Cancer Institute, Cairo University, Cairo, Egypt.

Naglaa Elkinaai (N)

National Cancer Institute, Cairo University, Cairo, Egypt.
Pathology Department, Children's Cancer Hospital Egypt-57357, Cairo, Egypt.

Amal Refaat (A)

National Cancer Institute, Cairo University, Cairo, Egypt.
Radiodiagnosis Department, Children's Cancer Hospital Egypt-57357, Cairo, Egypt.

Mai Amr Elahmadawy (MA)

National Cancer Institute, Cairo University, Cairo, Egypt.
Nuclear Medicine Department, National Cancer Institute, Cairo University, Cairo, Egypt.

Fadwa Said (F)

Department of Clinical Pathology, Cairo University, Cairo, Egypt.

Salma Elmenawi (S)

Clinical Research Department, Children's Cancer Hospital Egypt-57357, 1 Seket Al-Emam Street, El-Madbah El-Kadeem Yard, El-Saida Zenab, Cairo, Egypt. s.menawi@gmail.com.

Classifications MeSH