Surgery 1 (Neuroblastoma)

tuab_31a_n.jpg: Operative findings in an 1.10-year-old girl. Close to the left side of the large retractor (the right side of the patient) an indistinct mass is visible a few cm in diameter. tuab_31b_n.jpg: Following further preparation the mass sticks to a stalk, and here and there, a yellow zone is recognizable similar to an adrenal gland. The transverse colon is mobilized downward; behind it, parts of the right hepatic lobe are visible. tuab_31a_n.jpg and tuab_31b_n.jpg: It is a so-called second look operation in a neuroblastoma of the right adrenal gland. Nowadays, in neuroblastoma often initially a biopsy is performed for histological and biological diagnosis, and for definition of the type of tumor, upon which chemotherapy follows. Finally, the smaller residual tumor is totally removed in a second look operation. In contrast to neuroblastoma the treatment of nephroblastoma consists in stage 1 (I) of a primary tumor nephrectomy. Exceptions are very large nephroblastoma cases of stage 1 (I) and of course nephroblastoma with stage 2 (II) to stage 5 (V).