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Sympathetic Pathways: Collateral Ganglia and Adrenal Medulla01:27

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The sympathetic pathways of the collateral ganglia and adrenal medulla serve unique but interconnected roles in the sympathetic response.
Collateral Ganglia
Sympathetic preganglionic axons reach the collateral ganglia along the route of splanchnic nerves. These nerves bypass the sympathetic trunk and communicate with sympathetic postganglionic neurons housed in the prevertebral ganglia. These ganglia supply the organs of the abdominopelvic cavity.
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The adrenal or supra-renal glands, situated above the kidneys and aligned with the twelfth rib, are paired pyramid-shaped structures crucial for the body's stress response. During stress, these glands secrete hormones vital for adaptive physiological reactions.
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Adrenal hormones play a pivotal role in maintaining the body's electrolyte balance and orchestrating responses to stress, showcasing the intricate functions of the adrenal cortex and medulla.
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The response to stress—be it physical or psychological, acute or chronic—involves activation of the Hypothalamic-Pituitary-Adrenal (HPA) axis. The HPA axis is part of the neuroendocrine system because it involves both neuronal and hormonal communication. Its function is to regulate homeostatic systems—metabolic, cardiovascular, and immune—providing the necessary means to respond to a stressor.
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Related Experiment Video

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Zebrafish Model of Neuroblastoma Metastasis
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Bilateral adrenal neuroblastoma.

Perle Maliszewicz Pagès1, Christelle Dufour, Sylvie Fasola

  • 1Department of Pediatric Oncology, Institut Gustave Roussy, Villejuif, France. perle.pages@trs.aphp.fr

Pediatric Blood & Cancer
|October 28, 2008
PubMed
Summary

Bilateral adrenal neuroblastoma, though rare, often has a favorable prognosis, especially stage 4S cases. Aggressive surgery is generally not recommended due to low relapse rates and risk of adrenal failure.

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Area of Science:

  • Pediatric Oncology
  • Cancer Research
  • Clinical Medicine

Background:

  • Bilateral adrenal neuroblastoma is an exceptionally rare condition, with only 45 cases previously documented.
  • This study focuses on a cohort of 15 patients to further understand this rare presentation.

Purpose of the Study:

  • To analyze the characteristics and outcomes of bilateral adrenal neuroblastoma.
  • To compare findings with existing literature and inform treatment strategies.

Main Methods:

  • Retrospective review of 15 bilateral adrenal neuroblastoma cases treated between 1988-2004.
  • Comparison of this cohort with 45 previously reported cases from the literature.

Main Results:

  • Median age at diagnosis was 4 months, with 86.6% of patients being infants.
  • Stage 4S (International Neuroblastoma Staging System) was prevalent (10/15 patients in this cohort), significantly higher than in other neuroblastoma cohorts.
  • Five-year overall survival for stage 4S was 90%.

Conclusions:

  • Most bilateral neuroblastomas have a favorable prognosis, similar to unilateral cases.
  • Aggressive surgical approaches are discouraged due to low relapse rates and the risk of adrenal insufficiency.
  • Exceptional cases with risk factors like amplified MYCN warrant treatment comparable to high-risk unilateral neuroblastoma.