Neuroblastoma | Diagnosis & Treatment

How is neuroblastoma diagnosed?

Your child’s doctor will perform a complete medical and physical examination. In addition, your child’s physician may order one or more of the following tests:

Neuroblastoma tumor risk groups

Diagnosing neuroblastoma also involves determining the neuroblastoma risk group, which will help your child’s doctor determine neuroblastoma treatment options and prognosis. Children with neuroblastoma are divided into three risk groups depending on their age, the stage of the tumor and certain biological factors of the tumor. The three risk groups are low, intermediate and high.

Staging the tumor

Staging describes the size of the tumor and whether or not it has spread. The most commonly used staging system is the International Neuroblastoma Staging System:

  • Stage 1 — localized tumor that is completely surgically removed at diagnosis
  • Stage 2 — localized tumor that cannot be completely surgically removed at diagnosis. Lymph nodes on the same side of the tumor may have tumor cells present
  • Stage 3 — large tumor that has spread across the middle of the body and cannot be surgically removed at diagnosiss
  • Stage 4 — tumor of any size that has metastasized (spread) to distant lymph nodes, bone marrow, bone or livers
  • Stage 4s — special stage that applies only to a child less than 1-year-old. Small, localized tumor that has metastasized (spread) to liver, skin and/or bone marrows

What are the treatment options for neuroblastoma?

Your child’s physician will determine a specific course of neuroblastoma treatment for your child based on the tumor risk group and other factors. Neuroblastoma treatment may include:

These neuroblastoma treatments can be used alone or in combination depending on the neuroblastoma risk group.

Low-risk neuroblastoma

Patients with low-risk neuroblastoma usually require only surgery and/or observation. Occasionally, a patient with a low-risk tumor will need chemotherapy (or radiation treatment) to shrink a tumor before it is removed.

Intermediate-risk neuroblastoma

Patients with intermediate-risk disease are treated with chemotherapy to shrink the tumor, before the tumor can be surgically removed. The actual medications used are chosen to try to minimize side effects, both during treatment and in the future.

High-risk neuroblastoma

High-risk neuroblastoma is an aggressive disease that is treated with a combination of therapies including chemotherapy, surgery, radiation, stem cell transplant, biologic therapy, MIBG therapy and immunotherapy