http://www.cancer.gov/cancerinfo/pdq/treatment/neuroblastoma/healthprofessional/ Neuroblastoma is predominantly a tumor of early childhood, with two thirds of the cases presenting in children younger than 5 years. In rare cases, neuroblastoma can be discovered prenatally by fetal ultrasonography. Neuroblastoma originates in the adrenal medulla or the paraspinal sites where sympathetic nervous system tissue is present. The most common symptoms are due to a tumor mass or to bone pain from metastases. Proptosis and periorbital ecchymosis are common and arise from retrobulbar metastasis. Extensive bone marrow metastasis may result in pancytopenia. Abdominal distention with respiratory compromise due to massive liver metastases occurs in infants. Because they originate in paraspinal ganglia, neuroblastomas may invade through neural foramina and compress the spinal cord, causing paralysis. Fever, anemia, and hypertension are found occasionally
additional information as well about the severity of disease. They can yield useful prognostic information and establish a baseline for treatment monitoring and disease progression. Often, several diagnostic modalities can be used to seek a diagnosis in a symptomatic patient. Each test has unique characteristics of which a clinician should be aware. For example, both thoracic radiographs and computed tomography (CT) scan can be used to evaluate pulmonary metastases. CT scan is the more sensitive modality due to superior contrast resolution and diminished anatomic superimposition.[3,4] CT may be less specific though, since it detects more lesions, many of which may be nonneoplastic. It would make sense to use CT scan as a screening test. However, it is less readily available, more expensive, and requires general anesthesia, which increases risk to the patient and cost to the owner. Therefore, radiographs are still more commonly used
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