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An Infant with Spontaneous Tumor Regression

Viktor Urbanchich, Kalina Chavdarova, Violeta Dimitrova, Stayko Chavdarov, Georgi Guzgunov

Abstract

Introduction: Neuroblastoma is a developmental tumor arising from the embryonic sympathoadrenal lineage of the neural crest, with extracranial localization in most cases. It is the primary cause of death from pediatric cancer for children between the age of 1 and 5. However, many infants under 18 months have a high likelihood of undergoing spontaneous regression without chemotherapy.

This is the case of an infant  with a tumor mass, located in the posterior cranial fossa and  diagnosed with congenital hydrocephalus.

The patient was a male, born in August 2015 by C-section. He had a birth weight of 3500 g, height - 49 cm, morphological gestational age - 38. He was diagnosed with malformation syndrome during the prenatal development.

Results: A CT scan of the infant’s head showed a 4/5 cm volumetric tumor mass in the middle line of the posterior cranial fossa, causing mass effect. After histological and CT evaluation the tumor was defined as neuroblastoma. It was established to be inoperable because of its invasive character, engaging the cerebellum and upper spinal structures. In addition, transfontanelle ultrasound was made and suggested evidence for hydrocephalus and dilatation of the third and both lateral ventricles. As a palliative measurement a ventriculoperitoneal anastomosis was made. After a couple of months, a second ventriculoperitoneal anastomosis was needed and the new CT scan of the head showed no signs of the existing neuroblastoma.

Conclusion: Neuroblastomas show a remarkable capacity to undergo spontaneous regression. A greater understanding of the mechanisms and further exploration of this issue might allow the identification of tumours that have the capacity to undergo spontaneous regression and to induce regression in susceptible tumours using pharmacological, biological or immunological approaches.


Keywords

tumor regression , congenital hydrocephalus


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