AB053. Lessons from managing an 11-year-old girl with a calvarial neuroblastoma in a resource-limited setting: a case report
Abstract

AB053. Lessons from managing an 11-year-old girl with a calvarial neuroblastoma in a resource-limited setting: a case report

Donny Argie1, Patrick Putra Lukito1, Julius July2

1Department of Surgery sub Neurosurgery, RSUD WZ Johannes Kupang, Faculty of Medicine, Universitas Nusa Cendana, Kupang, Indonesia; 2Department of Neurosurgery, Neuroscience Center Siloam Hospital, Faculty of Medicine, Universitas Pelita Harapan, Tangerang, Indonesia

Correspondence to: Donny Argie MD. Department of Surgery sub Neurosurgery, RSUD WZ Johannes Kupang, Faculty of Medicine, Universitas Nusa Cendana, Moch. Hatta St. No. 9, Kupang, East Nusa Tenggara 85111, Indonesia. Email: donny.argie@gmail.com.

Background: Neuroblastoma is a common solid extracranial tumor in children which usually presents at an early age. It has a high propensity to metastasize and the skull is one of its favored metastatic sites. Here, we reported a case of a neuroblastoma lesion in the skull managed in a resource-limited setting and discussed potential pitfalls.

Case Description: We presented our case as a descriptive report in accordance with the CARE case report guideline. An 11-year-old girl was referred to the neurosurgery clinic with a large lump on her left head which was discovered 2 weeks prior. Aside from an intermittent headache, she was otherwise healthy. A non-contrast head computed tomography (CT) scan showed a bone destruction by an isodense mass on the right parietal region which extended to the extradural space. Interestingly, a sunburst appearance was noted within the tumor mass. Complete tumor removal was performed and the dura was macroscopically intact. She was later discharged without any symptoms. Initial histopathological result was inconclusive and the samples had to be sent to another facility for immunohistochemistry examinations. The result came back supporting the diagnosis of neuroblastoma. As neuroblastoma in the skull was most likely a result of metastasis, we scheduled the patient for further work-up examinations. Unfortunately, due to financial reasons, she and her parents were unable to travel back to the hospital.

Conclusions: Neuroblastoma should still be considered in older children with neoplastic skull lesion. A high degree of suspicion for neuroblastoma and other metastatic skull lesions is important and would allow clinicians to perform required diagnostic examinations to establish the primary site in the shortest time possible and prevent loss to follow-up. This is especially important in a resource-limited setting where the patients often come from families with low socioeconomic status. Subsequent follow-up and hospital visits impose additional costs which most of them cannot afford.

Keywords: Metastasis; pediatric neuroblastoma; resource-limited setting; skull lesion; case report

Acknowledgments

Funding: None.

Footnote

Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://cco.amegroups.com/article/view/10.21037/cc0-24-ab053/coif). The authors have no conflicts of interest to declare.

Ethical Statement: The authors are accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and national research committees and with the Helsinki Declaration (as revised in 2013). Written informed consent was obtained from the patient for publication of this case report and accompanying images. A copy of the written consent is available for review by the editorial office of this journal.

Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the noncommercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0/.

Cite this abstract as: Argie D, Lukito PP, July J. AB053. Lessons from managing an 11-year-old girl with a calvarial neuroblastoma in a resource-limited setting: a case report. Chin Clin Oncol 2024;13(Suppl 1):AB053. doi: 10.21037/cco-24-ab053

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