Introduction
Neuroblastomas are neuroendocrine tumors which arise from neural crest cells in the developing sympathetic nervous system.1Neuroblastoma is the most common extracranial solid tumor in pediatric populations and the most common malignancy in infancy.2 The patient described was staged IV-S by the INSS definition and MS by the INRGSS definition. Stage MS is a distinct pattern of disease in infants less than 18 months of age and characterized by metastatic spread to the liver, skin, and limited bone marrow involvement.3 Stage MS generally infers a good prognosis with survival approximated at 70-90% depending on clinical and genetic favorability and frequently with the outcome of spontaneous regression.4, 5 Late recurrence of neuroblastoma, defined as recurrence greater than five years after diagnosis, is rare occurring in 3.1% of all cases and is associated with poor survival outcomes.6,7 This case was compelling due to the unusual presentation of a very late recurrence of neuroblastoma in a young adult patient with history of stage MS disease and the overall favorable treatment response of her relapsed disease.