Primary resection following arterial embolization for the adrenal neuroblastoma in a child with intraabdominal hemorrhage: A case report

Abstract

Neuroblastoma in children over 18 months of age is usually advanced when detected and primary resection is not feasible. We experienced treating an 18-month-old boy with a huge right adrenal mass presenting as an intraabdominal hemorrhage. He developed hemorrhagic shock and underwent arterial embolization as a life-preserving therapy. The embolization was temporarily effective in stabilizing the patient’s circulatory condition. The patient underwent primary resection of the tumor after three embolizations in order to control recurrent bleeding, followed by full-dose chemotherapy and radiotherapy. The patient has been free from disease for 4 years after the treatments. Bleeding from neuroblastoma should be recognized as an oncologic emergency. The arterial embolization of pediatric tumors, which is uncommon in children, proved to be an effective option for controlling life-threatening hemorrhage.