الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
The adrenal gland is one of the most common sites of neoplasia in children age groups. Neuroblastoma is the most common tumor and to less extent adrenocortical functional tumors, incidentalomas, pheochromocytoma and other non-specific tumors.
Neuroblastoma, which originates from neural crest cells, is the most common extra cranial solid tumor in children accounting for 7-10% of all childhood cancers. It’s presented clinically with manifestation related to the tumor site (abdominal pain and distention), the tumor metastasis (bone marrow impaired function and raccoon eyes), to the effect of the tumor byproducts, or incidentally found with fetal US. Once neuroblastoma is suspected clinically, the diagnosis should be confirmed with laboratory testing of elevated levels of catecholamines and the imaging studies to localize the tumor. However, the complete establishment of the diagnosis must be either with a tumor biopsy or finding tumor cells in bone marrow biopsy or aspirate. The neuroblastomabiopsying is also essential for the planning of management and prediction of prognosis.
Neuroblastoma is managed according to Risk-Based Management System. Surgical resection is curative in case of localized neuroblastoma. However, surgery may be a part of multidisciplinary management in the patients with advanced regional and metastasicneuroblastomas. The chemotherapy is often needed with the surgery as the complete surgical resection with negative microscopic margins is almost impossible and the disease is usually diagnosed late after metastasis. The radiation therapy is used with high risk and resistant cases and retinoic acid is used with chemo-resistant cases. Bone marrow/stem cell transplantation may be needed with patients after long course of chemotherapy and radiotherapy.