2019 Volume 56 Issue 5 Pages 459-463
Introduction: Although the prognosis of pelvic peripheral neuroblastic tumors (PNTs) is good, chemotherapies are frequently chosen over a surgical operation as the initial treatment strategy because such tumors surround neurons and vessels with an anatomical regional problem.
Case: A 1.5-year-old girl had a pelvic solid tumor and the diagnosis based on the histopathological analysis of biopsy specimens was differentiating-subtype, low-mitosis-karyorrhexis-index (MKI) neuroblastoma of favorable histology (FH) type based on the International Neuroblastoma Pathology Classification (INPC). A mild chemotherapy was conducted because the tumor might arise from the sacral plexus and complete total resection was impossible. However, because there was no response to the first chemotherapy in terms of tumor size and tumor marker levels, we chose to perform surgery instead of several courses of chemotherapies.
Conclusion: The initial chemotherapy did not cause apoptosis of the PNTs, which means that the tumor cells had already started to differentiate, and there was a low probability of a decrease in tumor size. FH-type neuroblastoma is not essentially different from ganglioneuroblastoma, intermixed and ganglioneuroma, and surgical therapy should be a priority.
