Incidental Neuroblastoma

5-month-old boy who was taken to the pulmonology clinic with a 2-month history of coughing.The boy did not have any other associated symptoms, and his vital signs and physical examination were normal.

Imaging

An anteroposterior chest radiograph showed a fusiform mass in the left paraspinal region that formed an obtuse angle with the spine. A subsequent computed tomographic image of the chest showed a posterior mediastinal mass. Radiologic features of the mass included calcifications, heterogeneous enhancement, and extension into the intervertebral foramina.

Pathology

Histopathological examination of a surgical biopsy specimen revealed that the boy had neuroblastoma. Neuroblastoma is a tumor derived from neural crest cells that arises in tissues of the sympathetic nervous system. When the tumor originates from the paravertebral sympathetic ganglia in the chest, it may be detected incidentally on a chest radiograph. In this case, compression of the lung tissue by the mass was thought to be the cause of the patient’s cough.

Treatment

Due to the patient’s young age at diagnosis, genetic testing for familial neuroblastoma was performed and was negative. The patient underwent partial surgical resection of the tumor, and chemotherapy was administered. At a 1-year follow-up visit, the patient was well and had no tumor recurrence.

Conclusion

The article highlights the importance of incidental findings on radiologic imaging and also emphasizes the importance of genetic testing in patients with neuroblastoma, particularly in young patients, to determine if there is a familial predisposition to the disease.