May 6, 2009

How to investigate a suspected c/o Neuroblastoma

Neuroblastoma arises from adrenal medulla in majority of cases, however it may arise from any organ having neural crest cells.

Hematological & Biochemical tests:
Complete blood count
Biochemistry including serum LDH & serum ferritin

Diagnostic & Prognostic tests:
CT Scan of primary region
Urinary VMA (Vanillyl mandelic acid) and HMV (Homovanillic acid)
MIBG (131I-meta-iodobenzyl guanidine) scan
Tru-cut needle biopsy of the tumor
N-myc amplification
DNA index

Metastatic Work-up
Chest X-Ray
Bone marrow aspiration & Biopsy
MRI spine ( If neurological symptoms)
Bone scan