Neuroblastoma is one of the most common cancers affecting children today, forming 8%-10% of the total seen from birth through age 14 years. Neuroblastoma occurs with slightly more frequency in males than in females. The median age at diagnosis is 2 years. It develops from the tissues that form the sympathetic nervous system. Neuroblastoma typically begins in the abdominal area either in the adrenal gland (located just above the kidney) or around the spinal cord in the neck, chest, or pelvis. Although neuroblastoma often is present at birth, it generally is not detected until the tumor begins to grow and compress the surrounding organs. Cancer cells can metastasize (spread) quickly to other areas of the body, such as lymph nodes, liver, lungs, bones, the central nervous system and bone marrow. Close to 70 percent of children diagnosed with neuroblastoma will have metastatic disease. It has a wide range of "virulence"; children with localized neuroblastoma can be cured by surgery alone but those with bone metastases usually have a fatal outcome (CANCER, 59:1853-1859, 1987).

The most common symptoms include the following:

	An abdominal mass, either felt during an examination or seen as a swollen abdomen .
	Uncontrolled eye movement caused by the tumor
	Swelling and bruising of the area around the eyes, caused by metastases (tumor spread)
	Compression of kidney or bladder by the tumor may cause changes in urination
	Pain, limping or weakness may be present from bone involvement
	Anemia or bruising may be present if there is bone marrow involvement
	Paralysis and weakness may be present if there is spinal cord involvement
	Diarrhea caused by a substance produced by the tumor (vasoactive intestinal peptide or VIP) may be present
	Fever