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Review
. 2019 Feb 15;12(2):e226038.
doi: 10.1136/bcr-2018-226038.

Neuroblastoma with an unusual ovarian metastasis in a 5-year-old girl

Carla Steytler  1 , Ahmed A Darwish  1   2 , Sergey Popov  3 , Cathy Morley-Jacob  4 , Daniel C Aronson  1   5
Affiliations
Review

Neuroblastoma with an unusual ovarian metastasis in a 5-year-old girl

Carla Steytler et al. BMJ Case Rep. .

Abstract

Neuroblastoma metastasizing to the ovary is rare. We report the 10th case and review the scarce literature. A 5-year-old girl with stage M neuroblastoma presented with an upper abdominal and a pelvic mass. Evaluation after induction showed very good tumour response with three remaining localisations: two abdominal and one pelvic. At gross total resection, the pelvic mass appeared to be the enlarged and abnormal right ovary and was removed completely. Pathology showed an ovarian metastasis. On completion of her postoperative treatment, she achieved complete remission. Literature review showed that underdiagnosing of ovarian metastasis in neuroblastoma is very likely.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
(A) and (B) MRI at diagnosis. Tumour ingrowth into the upper pole of the right kidney. Ao, aorta; IVC, inferior vena cava; LM, liver metastases; NB, neuroblastoma.
Figure 4
Figure 4
Pathology of the right ovary. (A) Poorly differentiated neuroblastoma was diagnosed in the initial core biopsy (May 2016). Nests of tumour cells were surrounded by thin fibrovascular septa. (B) Ovary (arrow head) with metastatic neuroblastoma showing prominent chemotherapy-induced changes (necrosis, sclerosis) and only few clusters of viable tumour cells (arrow). Surgical resection August 2016. (C) Higher magnification of the previous image with tumour cells showing some degree of differentiation. Compared with the initial biopsy, the cells are bigger and have prominent nucleoli. (D) Strong expression of synaptophysin in the tumour cells.
Figure 2
Figure 2
MRI preoperative. (A) Note impressive tumour reduction with normal liver but tumour still invading the right kidney (*). (B) Remaining pelvic mass.
Figure 3
Figure 3
Macroscopic view—ovary replaced by tumour with chemotherapy-induced changes.
See this image and copyright information in PMC

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