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: email@example.com).
Received April 24, 2012
Accepted January 8, 2013