Spontaneous regression of a > 5cm infant neuroblastoma
after a three-fold volume increase without life or organ threatening
features
Abstract
Spontaneous tumour regression is a well-recognised phenomenon in
infantile favourable-biology neuroblastoma. An ‘expectant-observation’
strategy avoids chemotherapy or surgery associated risks but has mostly
been limited to small tumours (diameter < 5 cm) and
discontinued if significant tumour growth or increasing catecholamine
levels. Here we report the successful use of an observation-only
strategy in an infant with unresectable neuroblastoma > 5
cm at diagnosis which initially tripled in size with a 10-fold increase
in urinary catecholamines. We highlight the need for consensus
evidence-based criteria to define the subgroup where a ‘wait-and-see’
approach is appropriate and criteria to begin active treatment.