Neuroblastoma is the commonest extracranial solid tumour in childhood—approximately 6% of all childhood cancers. Tumours arise in sympathetic nervous tissue (adrenal 30%, abdomen 30%, thorax 15%). The peak age incidence is 1-3 years of age.

Localized intra-thoracic neuroblastoma may present with cough, pain, or Horner's syndrome or be detected on a chest X-ray (taken for an unrelated symptom). With abdominal disease there may be pain, abdominal distension, or general malaise. Bone or bone marrow metastases usually result in the child developing non-specific limb, joint, or back pain, which may be misdiagnosed as arthritis or irritable hip. There may be persistent unexplained fever. Pancytopenia from bone marrow involvement causes anaemia, petechiae, or infection. Periorbital ecchymoses indicate disseminated neuroblastoma.

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