Cystic neuroblastoma with hepatic metastasis: report of one case

Neuroblastoma is the most common infant malignancy, but cystic neuroblastoma is a rare presentation of this disease. There were only thirty-one reported cases in literature. Here we report another case. A 4-month-old female baby presented with a huge abdominal mass which was histologically proved to be a cystic neuroblastoma. Her urinary vanillylmandelic acid (VMA) was elevated. The image studies, including abdominal sonography, computed tomography, and magnetic resonance image, revealed a huge main mass with calcification and septa in the abdominal cavity, and multiple metastatic nodules with septation in the liver. A three-layer fluid-fluid level was found in the main mass and also in the metastatic nodules. No previous report showed a three-layer fluid-fluid level in the cystic component of neuroblastoma like the case presented here. It may be evidence of easy hemorrhagic character of this tumor.