Neuroblastoma in Early Childhood: A Case Report and Literature Review

Abstract

Introduction: Neuroblastoma is an extremely rare pediatric neoplasm whose prognosis becomes poor as the age advances. It can be sporadic or nonfamilial in origin. It is primarily a tumor of abdominal origin from where it metastasis to lymph nodes, liver, intracranial and orbital sites, and central nervous system The purpose of this paper is to report a case in which scalp nodules and inguinal lymph node was the initial presenting sign of disseminated neuroblastoma in a 2 year-old child. Case Presentation: We report a rare case of metastasis of neuroblastoma in a 2-year-old child presenting complain of fever for several weeks, anorexia, loss of weight , arthralgia and  multiple scalp nodules and inguinal lymph node enlargement . Biopsy was receive from the scalp and inguinal lymph nodes  showed undifferentiated  tumor tissue where  medium sized atypical blastoid tumor cells were located in clusters and sheets in an eosinophilic sometimes fibrillary background showing blood vessels. The sinuses were also infiltrated by these tumor cells. Immunohistochemically, Pan Leucocyte antigen was negative as also myogenin and CD99. However, CD 56 and synaptophysin are strongly positive and the neuroblastoma marker was weakly positive in the neuropil-like structures and the cytoplasm of some tumor cells. Conclusion: The addition of our case to the literature offers new clinicopathological     data useful for better defining the diagnosis. The differential diagnosis of neuroblastoma in a child presenting with multiple scalp nodules and inguinal lymph node enlargement should be consider.