Simultaneous occurrence of advanced neuroblastoma and acute myeloid leukemia
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Published on: June 6, 2025
T M Santos-Machado1, M C Zerbini, L M Cristofani
1Hematology/Oncology Division, Children's Institute of the Clinics Hospital, University of São Paulo Medical School, São Paulo, Brazil.
Insights
This case study details a 4-year-old boy with simultaneous neuroblastoma and acute myelomonocytic leukemia. The rare co-occurrence highlights potential links and diagnostic considerations for pediatric malignancies.
Area of Science:
- Pediatric Oncology
- Hematology
- Cancer Research
Background:
- Neuroblastoma (NB) is a common pediatric cancer.
- Acute Myelomonocytic Leukemia (AML) is a rare blood cancer in children.
- Secondary malignancies can arise after cancer treatment.
Observation:
- A 4-year-old boy with stage IV neuroblastoma developed acute myelomonocytic leukemia (M4 AML) during treatment.
- The patient received standard chemotherapy for neuroblastoma.
- Histological confirmation post-mortem revealed simultaneous presence of both NB and M4 AML.
Findings:
- The study presents a unique case of simultaneous neuroblastoma and M4 AML.
- AML may develop as a secondary malignancy following neuroblastoma treatment.
- Misdiagnosis of one condition by the other is also a possibility.
Implications:
- This case underscores the importance of vigilant monitoring for secondary malignancies in pediatric cancer patients.
- Further research is needed to understand the mechanisms behind such dual diagnoses.
- Clinical awareness should be heightened for potential co-occurrence or misdiagnosis of these cancers.
Abstract:
The authors report the case of a 4-year-old boy with a diagnosis of stage IV neuroblastoma (NB), who had been treated with 6 cycles of cyclophosphamide, doxorubicin, cisplatin, and etoposide for 12 months. The patient reached partial remission and presented a diagnosis of acute myelomonocytic leukemia (M4 AML), confirmed by immunophenotyping. After 2 months of therapy for leukemia, the child died with both malignancies in activity. A necropsy histologically confirmed the simultaneity of the two diseases. The authors review the possibilities of this association. The review leads to the conclusion that AML can occur as a secondary malignancy after the onset of the neuroblastoma, or be suggested by a misdiagnosis. The simultaneous occurrence of both as described here is not, however, found in the literature, to the best of the authors' knowledge.
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