Silastic abdominal patch for temporary hepatomegaly in Stage IV-S neuroblastoma

Of our 174 neuroblastoma patients, 11 were classified as Stage IV-S. The primary tumor is usually small and there is widespread disease in the liver, skin, bone marrow, or any combination of these. The prognosis is favorable and radiation and chemotherapy should be avoided if possible. In some of these children the rapidly enlarging liver may cause respiratory distress and vena caval compression. The creation of a ventral hernia by means of a Silastic patch is a useful, temporary procedure during the life-threatening period of rapid growth and increased intra-abdominal pressure. Closure is simple once the liver has returned to normal.