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Symptomatic epidural compression in infants with neuroblastoma: a single-center experience with 5 cases
Maria Capasso1, Giuseppe Cinalli, Anna Nastro
1Department of Oncology, Santobono-Pausilipon Children's Hospital, Naples, Italy.
Insights
Early diagnosis and treatment for infants with neuroblastoma and epidural compression are crucial. This study suggests laminoplasty or chemotherapy can prevent severe complications like paraplegia.
Area of Science:
- Pediatric Oncology
- Neurosurgery
- Medical Diagnostics
Background:
- Neuroblastoma with symptomatic epidural compression in infants necessitates prompt diagnosis and treatment to prevent severe sequelae.
- Established guidelines for optimal management of this condition are lacking.
- Early intervention is critical to avoid long-term complications such as paraplegia.
Observation:
- Five infants with neuroblastoma and symptomatic epidural compression were analyzed.
- In 80% of cases (4/5), symptom onset to tumor diagnosis occurred within 3 to 8 days.
- No patient developed paraplegia, either before or after treatment.
Findings:
- Treatment strategies involved either initial laminoplasty followed by chemotherapy (3 patients) or initial chemotherapy (2 patients).
- All patients survived the follow-up period.
- No severe complications, including paraplegia, were observed post-treatment.
Implications:
- The findings suggest that prompt surgical decompression (laminoplasty) and/or chemotherapy are effective in managing neuroblastoma with epidural compression in infants.
- These approaches appear to prevent severe neurological deficits.
- Further research into standardized treatment protocols is warranted to optimize outcomes for affected infants.
Abstract:
Infants affected by neuroblastoma with symptomatic epidural compression require early diagnosis and appropriate treatment to avoid severe late complications. However, no established guidelines are available regarding the optimal treatment of these patients. We describe 5 such infants. The interval between the onset of symptoms and tumor diagnosis was 3 to 8 days in 4/5 cases. None developed paraplegia before or after treatment. Treatment for epidural compression included first-line laminoplasty followed by chemotherapy in 3 patients, and chemotherapy first in the remaining 2. To date, all are alive and none have developed severe complications after a follow-up of 9 to 39 months (median, 20).
