Childhood cancers are uncommon,
but are still the major disease-related death in children.
The symptoms are vague and occasionally insidious like fever and weight loss,
which are more common in patients with neuroblastoma (6),
with early diagnosis critical to the patient prognosis (5).
The detection of a retroperitoneal mass,
which is the main symptom in these patients (3.25) in 75-95% (26),
in children requires a fast and accurate operation (3).
Neuroblastoma affects mainly aged between 2 months and 2 years (23) and are slightly more common in caucasian (27) boys (25),
while the Wilms tumor or nephroblastoma (23) in 80% of cases,
affects between 1 and 5 years,
with a peak between 3 and 4 years (22,25,26).
This tumor in most cases resolve spontaneously,
leaving just a focus of fibrosis or calcification in adults (27).
Solid tumors account for approximately 30% of all pediatric malignancies (19),
and Wilms tumor and neuroblastoma as two of the most common abdominal malignancies (13),
and neuroblastoma the most common extracranial solid tumor malignancy (2.24),
and of all malignancies,
the second - 10% of all neoplasms (26) - behind,
leukemia (17).
However,
the most common malignant abdominal mass of childhood is the Wilms tumor (21,23),
which originates from metanephros (21),
then comes the neuroblastoma (22).
Should take into account that the primary renal neuroblastoma is rare (2),
corresponding to 30-35% of all neuroblastomas (26),
as well as its massive hemorrhage (15).
The diagnosis of Wilms tumor and neuroblastoma by imaging (ultrasound,
CT scan and MRI) features high accuracy (9),
even if the two are each other differential diagnoses (11.12),
taking into account that both the Wilms tumor as neuroblastoma are sporadic (4).
The neuroblastoma tumor appears as a highly immunogenic,
as demonstrated by the large number of antigens (1),
originated from neural crest cells (4,23).
This neoplasm may be undifferentiated or poorly differentiated and may be more common than people realize,
early recognition of the need to improve prognosis and treatment (6).
The treatment is very different from Wilms tumor (2),
including the surgical management (6).
Wilms tumor,
is commonly associated with other congenital anomalies and syndromes such as Beckwith-Wiedemann,
Perlman,
13 and 18 trisomies (21),
cerebral gigantism,
congenital hemihypertrophy,
aniridia and neurofibromatosis (23),
Drash Syndrome (22:27),
being bilateral in 4-13% of cases (21,23,26).
This association is due to abnormality in two loci on chromosome 11 (26).
Is rarely associated with metastasis at diagnosis (12),
with the most common site of metastasis to the lung (85% of cases),
followed by the liver and regional lymph nodes,
beyond local vascular invasion (21,23,25).
With proper treatment,
has about 85-90% survival (9.25).
Neuroblastoma usually presents itself when diagnosed at advanced stage (9.23),
requiring preoperative chemotherapy before surgical resection (9),
whereas most commonly presents metastasis (14),
usually to the skeleton,
bone marrow and lymph nodes (22).
Correlates with the syndromes like Klippel-Feil,
fetal alcohol syndrome,
Hirschsprung disease,
and also with Beckwith-Wiedemann syndrome (23).
The younger the patient at diagnosis,
greater your chance of survival (25).