The Neurology of Neuroblastoma : Neuroblastoma as a Neurobiological Disease

Neuroblastoma is the single most common solid tumor of childhood. Although children with small primary neuroblastomas alone are almost always cured by surgery, 65% of children with neuroblastoma already have large bulky tumors or metastatic disease by the time of initial diagnosis. For these children, the 5-year survival rate is only somewhere between 5% and 20% with therapies including surgery, radiation, chemotherapy, and bone marrow transplantation. Dr Schor outlines a new approach to these tumors in order to make a difference for these children. There is much information to support the notion that neuroblastomas represent a developmental aberration of the nervous system, rather than a de novo abnormality in a previously normal cell. While the remote, paraneoplastic effects of neuroblastoma are often the purview of the child neurologist, the neoplasm itself has been viewed and approached therapeutically in much the same manner as all other solid tumors, as the purview of the pediatric oncologist. This work takes the view that approaching neuroblastoma rather as a disorder of nervous system development offers new therapeutic possibilities for this common tumor of childhood.