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Symptomatic Epidural Compression in Infants With Neuroblastoma: A Single-Center Experience With 5 Cases

Capasso, Maria MD*; Cinalli, Giuseppe MD; Nastro, Anna MD; Giuliano, Maria MD*; Errico, Maria E. MD§; Caccioppoli, Umberto MD; Turco, Rossella MD*; Ruotolo, Serena MD*; Vetrella, Simona MD*; De Bernardi, Bruno MD; Rossi, Eugenio MD#; Quaglietta, Lucia MD*

Journal of Pediatric Hematology/Oncology: May 2013 - Volume 35 - Issue 4 - p 260–266
doi: 10.1097/MPH.0b013e31828d704e
Original Articles

Infants affected by neuroblastoma with symptomatic epidural compression require early diagnosis and appropriate treatment to avoid severe late complications. However, no established guidelines are available regarding the optimal treatment of these patients. We describe 5 such infants. The interval between the onset of symptoms and tumor diagnosis was 3 to 8 days in 4/5 cases. None developed paraplegia before or after treatment. Treatment for epidural compression included first-line laminoplasty followed by chemotherapy in 3 patients, and chemotherapy first in the remaining 2. To date, all are alive and none have developed severe complications after a follow-up of 9 to 39 months (median, 20).

*Department of Oncology

Department of Neurosurgery

Service of Neuro-radiology

§Service of Pathology

Division of Oncologic Surgery

#Service of Diagnostic Imaging, Santobono-Pausilipon Children’s Hospital, Naples

Department of Hematology and Oncology, Giannina Gaslini Children’s Hospital, Genoa, Italy

Supported in part by OPEN (Associazione Oncologia Pediatrica e Neuroblastoma) and by a Research Fund provided by the Italian Neuroblastoma Foundation.

The authors declare no conflict of interest.

Reprints: Bruno De Bernardi, MD, Department of Hematology and Oncology, Giannina Gaslini Children’s Hospital, Largo Gaslini 5, Genova 16147, Italy (e-mail: brunodebernardi@ospedale-gaslini.ge.it).

Received April 24, 2012

Accepted January 8, 2013

© 2013 Lippincott Williams & Wilkins, Inc.