Neuroblastoma in Adolescents and Children Older than 10 Years: Unusual Clinicopathologic and Biologic Features.

Creator(s)

Laura C. McCarthy, Children's Mercy Hospital
Katherine Chastain
Terrie Flatt, Children's Mercy HospitalFollow
Eugenio Taboada, Children's Mercy HospitalFollow
Robert E. Garola, Children's Mercy HospitalFollow
John Herriges, Children's Mercy HospitalFollow
Linda D. Cooley, Children's Mercy HospitalFollow
Atif Ahmed, Children's Mercy HospitalFollow

Document Type

Article

Publication Date

11-2019

Identifier

DOI: 10.1097/MPH.0000000000001485

Abstract

Neuroblastoma (NB) in children older than 10 years is rare. We reviewed our archives for patients with NB aged 10 to 18 years and summarized their clinicopathologic/genetic records. Of 96 patients, 4 patients were identified in this age group. Four tumors were abdominal; 1 patient had 2 tumors at diagnosis, one of which was presacral. Tumor sizes ranged from 3 to 20 cm. All tumors were high risk at clinical stages 3 and 4, with metastasis to bone marrow and other areas. Four tumors were poorly differentiated with unfavorable histology and one patient with bilateral adrenal disease had an intermixed ganglioneuroblastoma on one side. Another tumor exhibited pheochromocytoma-like morphology. MYCN amplification was present in bone marrow metastasis in one case. Complex chromosomal gains and 19p deletions were common. Exome sequencing revealed ALK variants in 2 cases and previously unreported MAGI2, RUNX1, and MLL mutations. All patients received standard chemotherapy and 2 patients received ALK-targeted trial therapy. Three patients died of disease, ranging 18 to 23 months after diagnosis. One patient has active disease and is receiving trial therapy. In conclusion, NB in children older than 10 years may exhibit unusual clinicopathologic and genetic features with large tumors, bilateral adrenal disease, rare morphologic features, complex DNA microarray findings and novel mutations. Patients often have grim prognoses despite genomic profiling-guided targeted therapy.

Journal Title

Journal of pediatric hematology/oncology : official journal of the American Society of Pediatric Hematology/Oncology

Volume

41

Issue

8

First Page

586

Last Page

595

MeSH Keywords

Adolescent; Antineoplastic Agents; Child; Female; Humans; Male; Neoplasm Metastasis; Neoplasm Proteins; Neoplasm Staging; Neuroblastoma; Prognosis

Keywords

Adolescent; Antineoplastic Agents; Child; Female; Humans; Male; Neoplasm Metastasis; Neoplasm Proteins; Neoplasm Staging; Neuroblastoma; Prognosis

Recommended Citation

McCarthy LC, Chastain K, Flatt TG, et al. Neuroblastoma in Adolescents and Children Older than 10 Years: Unusual Clinicopathologic and Biologic Features. J Pediatr Hematol Oncol. 2019;41(8):586-595. doi:10.1097/MPH.0000000000001485