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Journal of Korean Neurosurgical Society 2011;49(1): 68-70.
doi: https://doi.org/10.3340/jkns.2011.49.1.68
Neo-Adjuvant Chemotherapy Followed by Surgery for Extensive Calvarial Metastases of a Neuroblastoma.
Sang Deok Kim, Tae Young Jung, Shin Jung, Hee Jo Baek
1Department of Neurosurgery, Chonnam National University Research Institute of Medical Sciences, Chonnam National University Hwasun Hospital & Medical School, Gwangju, Korea. jung-ty@chonnam.ac.kr
2Department of Pediatrics, Chonnam National University Research Institute of Medical Sciences, Chonnam National University Hwasun Hospital & Medical School, Gwangju, Korea.
ABSTRACT
Neuroblastoma is a common tumor of children. We report a patient with extensive calvarial metastases of a neuroblastoma as an initial presentation. A 2-year-old girl presented with a history of gradually increasing head size and fever. A brain CT showed a multilobulated, large, extra-axial tumor involving both frontotemporoparietal areas with a sunray-spiculated hyperostosis of the skull and marked contrast enhancement. A brain MRI demonstrated extensive calvarial lesions with simultaneous involvement of the orbits. A biopsy was performed and a ganglioneuroblastoma was diagnosed. On systemic evaluation, an enlarged abdominal mass was detected. After neo-adjuvant chemotherapy, most of the tumors disappeared except for a tumor in the left parietal area; there was a corresponding decrease in the circumference of the head. We performed surgery for the remnant mass. Intensive chemotherapy was administered and a bone marrow transplantation was performed. Adequate neo-adjuvant chemotherapy followed by surgery to the neuroblatoma with extensive metastases to the skull and orbit may be helpful.
Key Words: Calvarium; Chemotherapy; Neuroblastoma; Metastasis
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