Extraabdominal Manifestations (Neuroblastoma)

tuab_17a_n.jpg: 2-year-old girl with a mass at the lateral side of the left neck. The overlying skin has a reddish discoloration. tuab_17b_n.jpg: 2-year-old girl with swelling of left lower leg above the external ankle. X-rays of the left lower leg in two planes: Loss of structure and distension of the distal left fibula. tuab_17a_n.jpg and tuab_17b_n.jpg: In both cases neuroblastoma metastases are present which are often in the beginning of the disease clinically in the forefront. This form of presentation occurs in 70 % of the children with neuroblastoma beyond the age of 1 year. In tuab_17a_n.jpg the metastasis lies in a cervical lymph node, and in tuab_17b_n.jpg in the left fibula (as an example of involvement of a hollow bone). Clinically, tuab_17a_n.jpg may be reminiscent of an acute lymphadenitis and tuab_17b_n.jpg Ewing's sarcoma, or chronic osteomyelitis. This type of presentation is not typical for nephroblastoma.