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.