Neuroblastoma in Jamaica

ABSTRACT

Neuroblastoma arises from the adrenal medulla and sympathetic nervous system and is mainly a disease of infancy and childhood. This is a malignant tumour which presents in many different ways and which on histological examination shows small dark round cells, sometimes gathered into "rosettes". neuroblastoma spreads easily. The primary site is usually retroperitoneal; these present with an abdominal mass due either to the primary neoplasm or to hepatic metastases. Skeletal metastasis occurs eventually and may be the presenting feature. Investigations in suspected cases should include skeletal radiological survey, marrow puncture and the estimation of urinary catecholamines and their metabolites. Fourteen Jamaican patients with this disease are reviewed. There was a delay in diagnosis in five patients and these patients are discussed in more detail. Six patients were not offered treatment and the other eight patients were treated in a variety of ways all with poor results. Emphasis is placed on the necessity for early diagnosis which depends largely on a high index of suspicion in children with a vague chronic pyrexial illness. The most useful current method of management is presented. (AU)