A 3-Year-old Child with Multifocal Primary (thoracoabdominal) Neuroblastoma- A Case Report and Review of Literature

IntroductionMultifocal primary neuroblastoma in the non-infantile age group is rare, posing challenges in risk stratification and surgery.Case reportA 3-year-old girl presented with an abdominal mass and elevated urinary VMA (218 mg/l). PET-CT showed FDG-avid masses in the left suprarenal and posterior mediastinum with regional paraortic nodes. A biopsy of the suprarenal and thoracic masses was suggestive of ganglioneuroblastoma and ganglioneuroma. She was stratified as an intermediate risk, with the bone marrow being uninvolved and non-amplified MYCN. Gross tumor resection was achieved at all the sites after 2 cycles of neoadjuvant chemotherapy. She received 2 more cycles of adjuvant chemotherapy and has been disease-free for the last 3 years.ConclusionMultifocal primaries in the non-infantile age group have favourable biological features and good outcomes.