Bilateral adrenal ganglioneuroblastoma with neuromelanin. Clinical and pathologic observations

A case of bilateral adrenal ganglioneuroblastoma in an adolescent boy is described. The clinical evolution was remarkable for its quiescent course, despite unfavorable prognostic indicators that included: intraabdominal primary site, large tumors on both sides of the midline, and "unfavorable" pathologic subtype. There was no family history of neuroblastomas. Production of neuromelanin was manifested by this unusual tumor. A review of published cases of multifocal neuroblastomas suggests that these tumors follow an uncommon natural history, at variance with the expected behavior of the usual unicentric and sporadic type of neuroblastoma.