Journal of Korean Neurosurgical Society

The Korean Neurosurgical Society (대한신경외과학회)
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Neo-Adjuvant Chemotherapy Followed by Surgery for Extensive Calvarial Metastases of a Neuroblastoma

  • Kim, Sang-Deok (Department of Neurosurgery, Chonnam National University Research Institute of Medical Sciences, Chonnam National University Hwasun Hospital & Medical School) ;
  • Jung, Tae-Young (Department of Neurosurgery, Chonnam National University Research Institute of Medical Sciences, Chonnam National University Hwasun Hospital & Medical School) ;
  • Jung, Shin (Department of Neurosurgery, Chonnam National University Research Institute of Medical Sciences, Chonnam National University Hwasun Hospital & Medical School) ;
  • Baek, Hee-Jo (Department of Pediatrics, Chonnam National University Research Institute of Medical Sciences, Chonnam National University Hwasun Hospital & Medical School)
  • Received : 2010.03.03
  • Accepted : 2011.01.07
  • Published : 2011.01.28
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Abstract

Neuroblastoma is a common tumor of children. We report a patient with extensive calvarial metastases of a neuroblastoma as an initial presentation. A 2-year-old girl presented with a history of gradually increasing head size and fever. A brain CT showed a multilobulated, large, extra-axial tumor involving both frontotemporoparietal areas with a sunray-spiculated hyperostosis of the skull and marked contrast enhancement. A brain MRI demonstrated extensive calvarial lesions with simultaneous involvement of the orbits. A biopsy was performed and a ganglioneuroblastoma was diagnosed. On systemic evaluation, an enlarged abdominal mass was detected. After neo-adjuvant chemotherapy, most of the tumors disappeared except for a tumor in the left parietal area; there was a corresponding decrease in the circumference of the head. We performed surgery for the remnant mass. Intensive chemotherapy was administered and a bone marrow transplantation was performed. Adequate neo-adjuvant chemotherapy followed by surgery to the neuroblatoma with extensive metastases to the skull and orbit may be helpful.

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References

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