neuroblastoma - novel: home · paraneoplastic (neuroblastoma) opsocolonus opsoclonus herald sign...
TRANSCRIPT
![Page 1: Neuroblastoma - NOVEL: Home · Paraneoplastic (Neuroblastoma) Opsocolonus Opsoclonus herald sign 2-3% . Mean age at onset 16 years . Youngest 4 months of age . Older than 2 years](https://reader031.vdocuments.site/reader031/viewer/2022021702/5d4ce04a88c9930e558b5544/html5/thumbnails/1.jpg)
Neuroblastoma 936-8
![Page 2: Neuroblastoma - NOVEL: Home · Paraneoplastic (Neuroblastoma) Opsocolonus Opsoclonus herald sign 2-3% . Mean age at onset 16 years . Youngest 4 months of age . Older than 2 years](https://reader031.vdocuments.site/reader031/viewer/2022021702/5d4ce04a88c9930e558b5544/html5/thumbnails/2.jpg)
Case Records
Of the
Massachusetts General Hospital
Case 27-1995
New England Journal of Medicine
1995;333:579-586
![Page 3: Neuroblastoma - NOVEL: Home · Paraneoplastic (Neuroblastoma) Opsocolonus Opsoclonus herald sign 2-3% . Mean age at onset 16 years . Youngest 4 months of age . Older than 2 years](https://reader031.vdocuments.site/reader031/viewer/2022021702/5d4ce04a88c9930e558b5544/html5/thumbnails/3.jpg)
Figure 1. Saggital ultrasound image of the left upper quadrant of the abdomen, showing a heterogenous left adrenal mass.
![Page 4: Neuroblastoma - NOVEL: Home · Paraneoplastic (Neuroblastoma) Opsocolonus Opsoclonus herald sign 2-3% . Mean age at onset 16 years . Youngest 4 months of age . Older than 2 years](https://reader031.vdocuments.site/reader031/viewer/2022021702/5d4ce04a88c9930e558b5544/html5/thumbnails/4.jpg)
Figure 2. Contrast-enhanced abdominal CT scan showing a 3.5 cm, heterogenous left adrenal mass.
![Page 5: Neuroblastoma - NOVEL: Home · Paraneoplastic (Neuroblastoma) Opsocolonus Opsoclonus herald sign 2-3% . Mean age at onset 16 years . Youngest 4 months of age . Older than 2 years](https://reader031.vdocuments.site/reader031/viewer/2022021702/5d4ce04a88c9930e558b5544/html5/thumbnails/5.jpg)
Figure 3. Sectioned surface of the left adrenal gland showing the tumor surrounded by a thin yellow rim of residual adrenocortical tissue.
![Page 6: Neuroblastoma - NOVEL: Home · Paraneoplastic (Neuroblastoma) Opsocolonus Opsoclonus herald sign 2-3% . Mean age at onset 16 years . Youngest 4 months of age . Older than 2 years](https://reader031.vdocuments.site/reader031/viewer/2022021702/5d4ce04a88c9930e558b5544/html5/thumbnails/6.jpg)
Figure 4. Nodular tumor and rim of the adrenal gland (hematoxylin and eosin, x4)
![Page 7: Neuroblastoma - NOVEL: Home · Paraneoplastic (Neuroblastoma) Opsocolonus Opsoclonus herald sign 2-3% . Mean age at onset 16 years . Youngest 4 months of age . Older than 2 years](https://reader031.vdocuments.site/reader031/viewer/2022021702/5d4ce04a88c9930e558b5544/html5/thumbnails/7.jpg)
Figure 5. Lymphoid tissue within tumor nodules (hematoxylin and eosin, x48).
![Page 8: Neuroblastoma - NOVEL: Home · Paraneoplastic (Neuroblastoma) Opsocolonus Opsoclonus herald sign 2-3% . Mean age at onset 16 years . Youngest 4 months of age . Older than 2 years](https://reader031.vdocuments.site/reader031/viewer/2022021702/5d4ce04a88c9930e558b5544/html5/thumbnails/8.jpg)
Figure 6. Round neuroblasts with a delicate fibrillary background (hematoxylin and eosin, x90).
![Page 9: Neuroblastoma - NOVEL: Home · Paraneoplastic (Neuroblastoma) Opsocolonus Opsoclonus herald sign 2-3% . Mean age at onset 16 years . Youngest 4 months of age . Older than 2 years](https://reader031.vdocuments.site/reader031/viewer/2022021702/5d4ce04a88c9930e558b5544/html5/thumbnails/9.jpg)
Figure 7. Ganglion cells mixed with lymphocytes (hematoxylin and eosin, x90).
![Page 10: Neuroblastoma - NOVEL: Home · Paraneoplastic (Neuroblastoma) Opsocolonus Opsoclonus herald sign 2-3% . Mean age at onset 16 years . Youngest 4 months of age . Older than 2 years](https://reader031.vdocuments.site/reader031/viewer/2022021702/5d4ce04a88c9930e558b5544/html5/thumbnails/10.jpg)
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%
![Page 11: Neuroblastoma - NOVEL: Home · Paraneoplastic (Neuroblastoma) Opsocolonus Opsoclonus herald sign 2-3% . Mean age at onset 16 years . Youngest 4 months of age . Older than 2 years](https://reader031.vdocuments.site/reader031/viewer/2022021702/5d4ce04a88c9930e558b5544/html5/thumbnails/11.jpg)
Rarely associated with elevated catecholamines (VMA, HVA metabolites) Anti-neurofilament protein antibodies (M V 210 K) ± in sera
Paraneoplastic (Neuroblastoma) Opsocolonus
![Page 12: Neuroblastoma - NOVEL: Home · Paraneoplastic (Neuroblastoma) Opsocolonus Opsoclonus herald sign 2-3% . Mean age at onset 16 years . Youngest 4 months of age . Older than 2 years](https://reader031.vdocuments.site/reader031/viewer/2022021702/5d4ce04a88c9930e558b5544/html5/thumbnails/12.jpg)
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
![Page 13: Neuroblastoma - NOVEL: Home · Paraneoplastic (Neuroblastoma) Opsocolonus Opsoclonus herald sign 2-3% . Mean age at onset 16 years . Youngest 4 months of age . Older than 2 years](https://reader031.vdocuments.site/reader031/viewer/2022021702/5d4ce04a88c9930e558b5544/html5/thumbnails/13.jpg)
http://www.library.med.utah.edu/NOVEL