INTRODUCTION
Neuroblastoma (NB) is the most common malignancy of
infancy.1 Spontaneous tumour regression is a
well-recognised phenomenon in low-risk, favourable-biology
cases.2 Complete regression may occur well after the
first year of life.2,3
Several groups have demonstrated the safe use of a ‘wait-and-see’,
observation-only strategy for low-risk infants with favourable
biology.3–12 This approach avoids risks associated
with unnecessary surgical and cytotoxic treatments, but no international
consensus on definition or criteria for treatment exists. The approach
has generally been limited to cases with small tumours (diameter
< 50 mm at diagnosis) and active treatment generally started
if a significant increase in tumour size or tumour markers were
observed.5–12
We discuss a case of an infant with NB where an observation-only
approach was successfully used despite a > 5 cm tumour
diameter at diagnosis which tripled in size with a 10-fold increase in
urinary catecholamines, before undergoing spontaneous tumour regression.