creators_name: Rajeshwari, K creators_name: Dravid, NV creators_name: Goyal, N creators_name: Gadri, A creators_name: Pawar, S creators_name: Karibasappa, GN creators_id: ujwalgk@gmail.com editors_name: Kakkilaya, Srinivas editors_id: Kakkilaya BS type: journale datestamp: 2014-02-25 12:40:58 lastmod: 2014-02-25 12:40:58 metadata_visibility: show title: Adolescent Neuroblastoma of Lower Limb ispublished: pub subjects: OJHAS full_text_status: public keywords: Neuroblastoma; Adolescent; Lower limb abstract: Neuroblastoma is an embryonic tumour of neural crest origin, commonly seen in children with upper abdomen involvement. Rarely neuroblastomas present in adolescents and adults involving lower limb. Histopathologically neuroblastoma of lower limb can be confused with other small round cell tumour especially with Ewing’s sarcoma and rhabdomyosarcoma. A 16 year old male presented with 15x11cm swelling, pain and multiple discharging sinuses of right leg since 4 months. Routine haematological and biochemical analysis were within normal limits. Radiology of right leg showed large soft tissue swelling encompassing the pathological fracture of tibia and bowing of fibula. Fine needle aspiration of the swelling revealed malignant small round cell tumour. Histopathology revealed poorly differentiated neuroblastoma of lower limb. The immunohistochemistry of Synaptophysin and Chromogranin were positive and CD 99 was negative. Neuroblastoma diagnosed at unusual site with uncommon age has poor prognosis. Hence, one must keep in mind the differential diagnosis of neuroblastoma as one of the differential diagnosis in evaluating the soft tissue tumours of lower limb. date: 2013-04-15 date_type: published publication: Online Journal of Health and Allied Sciences volume: 12 number: 1(9) publisher: Kakkilaya BS refereed: TRUE referencetext: 1. McLean TW, Iskandar SS, Shimada H, Hall MC. Neuroblastoma in an adult. Urology. 2004;64:1232. 2. Rubie H, Hartmann O, Michon J, et al. N-Myc gene amplification is a major prognostic factor in localized neuroblastoma: results of the French NBL 90 study. Neuroblastoma Study Group of the Societe Francaise d’Oncologie Pediatrique. J Clin Oncol. 1997;15:1171–1182. 3. Armstrong EA, Harwood-Nash DC, Ritz CR, et al. CT of neuroblastomas and ganglioneuromas in children. AJR. 1982;139:571–576. 4. Mackay B, Luna M A, Butler JJ. Adult Neuroblastoma. Cancer 1976;37:1334. 5. Enzinger FM, Weiss SW. Neuroepithelioma – peripheral neuroepithelioma (peripheral neuroblastoma). In Enzinger FM, Weiss SW. Soft tissue tumours. 2nd Edition. St. Louis, Washington. Mosby. 1988. p 806-809. 6. Feldman PS, Covell JL, Silverman JF et al. The diagnosis of neuroblastoma by fine needle aspiration cytology(Abstract). Acta Cytol 1985;29:950. 7. Conte M, De Bernardi B, Milanaccio C, Michelazzi A, Rizzo A, Montobbio G, et al. Malignant neuroblastic tumors in adolescents. Cancer Lett. 2005;228:271–274. 8. Conte M, Parodi S, De Bernardi B, Milanaccio C, Mazzocco K, Angelini P, et al. Neuroblastoma in adolescents: the Italian experience. Cancer. 2006;106:1409–1417. 9. Navid F, Armstrong M, Barfield RC. Immune therapies for neuroblastoma. Cancer Biol Ther. 2009;8:874–882. 10. Esiashvili N, Goodman M, Ward K, Marcus RB Jr, Johnstone PA. Neuroblastoma in adults: incidence and survival analysis based on SEER data. Pediatr Blood Cancer. 2007;49:41-46. citation: Rajeshwari, K and Dravid, NV and Goyal, N and Gadri, A and Pawar, S and Karibasappa, GN (2013) Adolescent Neuroblastoma of Lower Limb. [Journal (On-line/Unpaginated)] document_url: http://cogprints.org/9143/1/2013-1-9.pdf