High-Risk Adrenal Neuroblastoma with Bone Metastases in an 18-Month-Old

Abstract

Neuroblastoma is the most common extracranial malignant tumor in the pediatric population and a significant cause of morbidity and mortality. It arises from neural crest cells and exhibits a highly variable clinical course, ranging from spontaneous regression to widespread metastatic disease. We report the case of an 18-month-old child presenting with a limping gait and swelling of the left elbow. Radiographs demonstrated aggressive bone lesions in the left humerus and right femur, while ultrasound identified lymphadenopathy in the left axilla and right iliac region, as well as a right adrenal mass. Contrast-enhanced Computed Tomography confirmed the adrenal mass, which demonstrated image-defined risk factors, namely local organ infiltration. These findings are consistent with metastatic neuroblastoma. This case highlights the importance of comprehensive imaging in the diagnosis, staging and management of high-risk neuroblastoma.