ÇAĞLAR ÖDEK, TANIL KENDİRLİ, Esra PEKPAK, Ayhan YAMAN, Başak ADAKLI-AKSOY, HANDAN DİNÇASLAN, NURDAN TAÇYILDIZ, Emel ÜNAL, ERDAL İNCE, Gülsan YAVUZ

An unusual case of neuroblastoma: a 17-year-old adolescent presented with bilateral diffuse lung metastasis at initial diagnosis

Ödek Ç, Kendirli T, Pekpak E, Yaman A, Adaklı-Aksoy B, Dinçaslan H, Taçyıldız N, Ünal E, İnce E, Yavuz G. An unusual case of neuroblastoma: A 17-year-old adolescent presented with bilateral diffuse lung metastasis at initial diagnosis. Turk J Pediatr 2016; 58: 86-89.Neuroblastoma (NB) is the most frequently diagnosed neoplasm during infancy and its incidence declines within the first 3-5 years of life. It can be rarely diagnosed in adolescents and young adults. Adolescents have advanced stage of disease, higher frequency of uncommon metastatic sites such as lungs, and worse outcomes. Herein, we describe an unusual case of NB in a 17-yearold adolescent presented with lung metastasis at diagnosis. The patient was diagnosed with stage IV NB. Thorax high-resolution computed tomography (HRCT) scan revealed irregular septal thickening with ground glass opacity consistent with pulmonary parenchymal metastases. After the first cycle of chemotherapy he developed pulmonary hemorrhage and respiratory distress. He required ventilation support and mechanical ventilation was started. Metastatic nodules were determined on second thorax HRCT. We lost the patient due to septic shock and multiple organ failure 2 months after diagnosis. In conclusion, adolescents with NB have unfavorable prognosis. These patients may have lung metastases at diagnosis. Therefore, detailed chest imaging at initial diagnosis is crucial

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1. Brodeur GM, Hogarty MD, Mosse YP, Maris JM. Neuroblastoma. In: Pizzo PA, Poplack DG (eds). Principles and Practice of Pediatric Oncology (6th ed) Philadelphia: Lippincott Williams & Wilkins; 2011: 886-922.

2. Esiashvili N, Anderson C, Katzenstein HM. Neuroblastoma. Curr Probl Cancer 2009; 33: 333-360.

3. Conte M, Parodi S, De Bernardi B, et al. Neuroblastoma in adolescents: the Italian experience. Cancer 2006; 106: 1409-1417.

4. Maris JM, Hogarty MD, Bagatell R, et al. Neuroblastoma. Lancet 2007; 369: 2106-2120.

5. Pollack MM, Patel KM, Ruttimann UE. PRISM III: an updated Pediatric Risk of Mortality Score. Crit Care Med 1996; 24: 743-752.

6. Leteurtre S, Martinot A, Duhamel A, et al. Validation of the paediatric logistic organ dysfunction (PELOD) score: prospective, observational, multicentre study. Lancet 2003; 362: 192-197.

7. Bernard GR, Artigas A, Brigham KL, et al. The American-European Consensus Conference on ARDS: Definitions, mechanisms, relevant outcomes, and clinical trial coordination. Am J Respir Crit Care Med 1994; 143: 818-824.

8. Dellinger RP, Levy MM, Rhodes A, et al. Surviving sepsis campaign: international guidelines for management of severe sepsis and septic shock: 2012. Crit Care Med 2013; 41: 580-637.

9. Conte M, De Bernardi B, Milanaccio C, et al. Malignant neuroblastic tumors in adolescents. Cancer Lett 2005; 228: 271-274.

10. DuBois SG, London WB, Zhang Y, et al. Lung metastases in neuroblastoma at initial diagnosis: A report from the International Neuroblastoma Risk Group (INRG) Project. Pediatr Blood Cancer 2008; 51: 589-592.

11. Kammen BF, Matthay KK, Pacharn P, et al. Pulmonary metastases at diagnosis of neuroblastoma in pediatric patients: CT findings and prognosis. AJR Am J Roentgenol 2001; 176: 755-759.

12. Cowie F, Corbett R, Pinkerton CR. Lung involvement in neuroblastoma: incidence and characteristics. Med Pediatr Oncol 1997; 28: 429-432.