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Case Reports
. 2014 Jul 17:3:20.
doi: 10.1186/2162-3619-3-20. eCollection 2014.

Neuroblastoma of the elderly, an oncologist's nightmare: case presentation, literature review and SEER database analysis

Elisa Rogowitz #  1   2 , Hani M Babiker #  2   3   4 , Mohammed Kanaan  2   3   4 , Rebecca A Millius  5 , Q Scott Ringenberg  2 , Maria Bishop  2   3   4
Affiliations
Case Reports

Neuroblastoma of the elderly, an oncologist's nightmare: case presentation, literature review and SEER database analysis

Elisa Rogowitz et al. Exp Hematol Oncol. .

Abstract

Neuroblastoma is considered a pediatric malignancy as over 95% of cases are diagnosed in patients ≤10 years old. This cancer is extremely rare in elderly patients. We conducted a Surveillance, Epidemiology, and End Results (SEER) database analysis in the USA between 1973-2007 that revealed only 35 elderly patients (>60 years of age) with neuroblastoma of whom only 2 patients had primary mediastinal neuroblastoma. There is a paucity of treatment and survival outcomes data for the elderly owing to the rarity of neuroblastoma in this population. Currently there are no standard guidelines or protocols for treatment of adult neuroblastoma. We report a rare and challenging case of an 86-year old patient presenting with mediastinal neuroblastoma and syndrome of inappropriate antidiuretic hormone secretion (SIADH) successfully treated with resection. Herein, we also provide a review of the literature and updated survival data on neuroblastoma based on results of our SEER database review.

Keywords: Adult; Neuroblastoma; SIADH; Thymus.

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Figures

Figure 1
Figure 1
CT scan of the chest. Sagittal CT scan image of the chest reveals a large mediastinal mass measuring 5.2 × 4.7 cm. There is no hilar or mediastinal lymphadenopathy.
Figure 2
Figure 2
Body PET scan pre-surgery. PET scan of the chest and body reveals an anterior mediastinal mass measuring 5.0 × 5.1 cm with an SUV of 15. No additional suspicious masses or adenopathy are appreciated. There is an area of increased metabolic activity in the inferior aspect of the right hepatic lobe that is related to bowel activity.
Figure 3
Figure 3
Resected mediastinal mass surgical pathology. Hemotoxylin & Eosin stained section of resected mediastinal mass reveals scattered small Homer-Wright rosettes (arrows): small dark neuroblastoma cells in circular groups around pale fibrillary neuropil (200× magnification).
Figure 4
Figure 4
Body PET scan post-surgery. PET scan of the chest and body performed 7 months after surgical resection reveals no foci of abnormal FDG avid activity within the chest, no pulmonary nodules, and normal cardiomediastinal silhouette appearance.
See this image and copyright information in PMC

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