neuroblastoma 936-8. case records of the massachusetts general hospital case 27-1995 new england...
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Neuroblastoma936-8
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Case Records
Of the
Massachusetts General Hospital
Case 27-1995
New England Journal of Medicine
1995;333:579-586
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Figure 1. Saggital ultrasound image of the left upper quadrant of the abdomen, showing a heterogenous left adrenal mass.
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Figure 2. Contrast-enhanced abdominal CT scan showing a 3.5 cm, heterogenous left adrenal mass.
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Figure 3. Sectioned surface of the left adrenal gland showing the tumor surrounded by a thin yellow rim of residual adrenocortical tissue.
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Figure 4. Nodular tumor and rim of the adrenal gland (hematoxylin and eosin, x4)
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Figure 5. Lymphoid tissue within tumor nodules (hematoxylin and eosin, x48).
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Figure 6. Round neuroblasts with a delicate fibrillary background (hematoxylin and eosin, x90).
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Figure 7. Ganglion cells mixed with lymphocytes (hematoxylin and eosin, x90).
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Paraneoplastic (Neuroblastoma) Opsocolonus
Opsoclonus herald sign 2-3%
Mean age at onset 16 years
Youngest 4 months of age
Older than 2 years in only 13%
Mediastinal tumor in 49-61%
Tumor found within 3 months in 60%
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Rarely associated with elevated catecholamines (VMA, HVA metabolites)
Anti-neurofilament protein antibodies (M V 210 K) ± in sera
Paraneoplastic (Neuroblastoma) Opsocolonus
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Survival rate 90% two-year c.f. 30-34% other neuroblastoma cases
Tumor removal may decrease, have no effect or exacerbate opsoclonus
Spontaneous resolution may take months or years
Paraneoplastic (Neuroblastoma) Opsocolonus
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http://www.library.med.utah.edu/NOVEL