Long-term urological complications in survivors younger than 15 months of advanced stage abdominal neuroblastoma
M A Koyle1, D A Hatch, P D Furness
1Department of Pediatric Urology, Children's Hospital and University of Colorado School of Medicine, Denver, Colorado, USA.
Purpose:
We evaluated the long-term urological complications in survivors of infant advanced stage abdominal neuroblastoma.
Materials And Methods:
The records of patients who presented during an 8-year period with surgical problems related to the kidney and who had survived advanced stage (IV and IV-S) neuroblastoma were reviewed.
Results:
Of 7 patients identified 3 had complications of obstruction from retroperitoneal fibrosis and 4 had renal cell carcinoma. In the renal cell carcinoma group 3 patients had synchronous, multifocal, bilateral tumors and 1 had a tumor in a solitary kidney. Pathological examination of renal cell carcinoma revealed oncocytoidy with solid and papillary patterns. One patient underwent bilateral nephrectomy but in the remaining 3 renal preservation surgery was performed. All 7 patients have no progression of secondary complications 2 to 8 years after initial presentation.
Conclusions:
Survivors of advanced stage abdominal neuroblastoma may be predisposed to long-term urological complications well after initial diagnosis. Because of the risk of renal damage from obstruction secondary to retroperitoneal fibrosis, and the propensity to have renal cell carcinoma, close long-term followup using abdominal imaging is recommended.
