Surgery is important to establish the diagnosis and obtain enough tissue for pathology, molecular studies etc.
Biopsy may be obtained using a laparoscope or at limited laparotomy with incisional biopsy.
Only rarely is it possible to resect a neuroblastoma completely at diagnosis.
If tumor appears localized, every effort should be made to resect as much of the tumor as possible. At the operation, as well as removal of the primary, extent of disease should be assessed. Local lymph nodes should be biopsied and neural foramina inspected when relevant.
Tumor Studies
Cytogenetic studies are:
- Successful in high proportion of tumor samples.
- Karyotype abnormalities seen include 1p-, double minutes, chromatin bodies and homogenously staining regions (HSRs).
- HSRs and chromatin bodies are associated with N-myc amplification.
- Tumor N-myc amplification is associated with a poor prognosis.
Histopathology is:
- Important to determine prognosis (see path section).
- Diagnosis can be made from bone marrow aspiration and biopsy.
