Dickson PV et al. - In a study to review treatment of pts with neuroblastoma (NBL), focusing on those with an initial diagnosis of Wilms tumor (WT), to determine presenting features that would have suggested the correct preoperative diagnosis, it seems that although NBL can be mistaken for WT at presentation, presence of constitutional symptoms, or intratumoral calcification or vascular encasement on preoperative imaging should heighten suspicion for NBL. Laboratory evaluation, including urinary catecholamines, should be completed before surgery when the etiology of an abdominal tumor is uncertain Methods
Retrospective case cohort study reviewing charts and imaging of pts with NBL initially diagnosed clinically with WT
Preoperative symptoms, laboratory studies, and imaging were evaluated
Similar variables were assessed in the 20 pts with WT most recently treated
Results
9 pts with NBL were identified as those who had exploratory laparotomy with a preoperative diagnosis of WT; 8 underwent nephrectomy at exploration
Children with NBL had symptoms such as fever and weight loss at presentation more often than patients with WT
Preoperative computed tomography demonstrated intratumoral calcifications, vascular encasement, or both in 78% of pts with NBL but were never seen in WT pts
Preoperative urinary catecholamines were elevated in 5 pts ultimately diagnosed with NBL
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