1983 Volume 19 Issue 1 Pages 121-132
A fourteen month old boy was admitted to Niigata University Hospital with the presence of abdominal mass and an associated hard mass on his left supraorbital region. Close examinations revealed neuroblastoma with metastases to bone and liver. The operative findings disclosed a tumor originating from the left adrenal gland, swelling of the paraaortic lymph nodes and multi-nodular metastases of both lobes of the liver. Reduction surgery was carried out consisting of resection of the primary tumor and lymph nodes dissection. At the time, a specimen for biopsy was taken from the metastatic lesion of the left lobe of the liver. Microscopic examination revealed a composite type of ganglioneuroblastoma of the left adrenal tumor and a rosett-fibrillary type of neuroblastoma of the metastatic sites. Thereafter, multimodal therapy consisting of chemotherapy, immunotherapy and maturational therapy was performed. The supraorbital mass disappeared and metastases of the liver were not visible on CT film. The second look operation was performed 2 years and 6 months after the initiation of treatment. The operative findings disclosed metastatic lesions of the liver altered to scars. Microscopic examination of the scars revealed fibrous tissue alone, or fibrous tissue with irregularly scattered ganglion cells or benign ganglioneuroma with fibrosis, and did not disclosed any evidence of the neuroblastoma tissue. There was no recurrence in the retroperitoneal region. The patient has been well for 3 years after initiation of the treatment.
