A Metastatic Neuroblastoma with Long Survival in Adolescence

We report a 16-year 8-month-old girl with neuroblastoma (stageIII) who received surgery for abdominal masses four times duringa 52-month period. She is now treated with oral administrationof cyclophosphamide (2 mg/kg) and is in good condition eventhough she has several metastatic lesions. In this paper, we consider why a 16-year-old girl with a tumorof estimated stage III has had a long survival period of 52months. There seem to be three interesting points related toher long survival. The first is that the tumor response to thetreatments was good, particularly to a large dose of cyclophosphamide.The second is the histological observation of the tumor specimensobtained at four different occasions from the same or differentportions. The immature tumor cells of the primary tumor changedto ganglioneuroma during the first 30-month period, but thenewly appearing metastatic lymphnodes were histologically neuroblastoma.The third is her immunological condition during treatment. Thefact that her nonspecific humoral and cellular immune competenceremained in good condition seems to be a factor favorable forher good prognosis.