Isolated intraspinal relapse of neuroblastoma after autologous bone marrow transplantation

Neuroblastoma may present with spinal cord compression due to dumbbell extension of thoracic or abdominal disease. Isolated intraspinal involvement as the sole site of relapse is rare. Two infants with poor-prognosis stage IV neuroblastoma presented early after high-dose therapy and autologous bone marrow transplant with isolated spinal relapse heralded by misleading symptoms. The rarity of such isolated relapses is reviewed, and an etiologic hypothesis is proposed.