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Symptoms of neuroblastoma

Neuroblastoma may not cause any signs or symptoms in its early stages. Signs and symptoms often appear once the tumour grows into surrounding tissues. Other health conditions can cause the same symptoms as neuroblastoma.

One of the most common symptoms of neuroblastoma is pain. This pain is caused by the tumour pressing on nearby tissues as it grows or by the cancer spreading to bones. Other signs or symptoms will depend on the location of the tumour, if the tumour makes chemicals that go into the bloodstream and if the cancer has spread elsewhere in the body.

Neuroblastoma most commonly develops in infants and children younger than 5 years old. In infants, neuroblastoma develops most often in the chest and neck. In toddlers and older children, neuroblastoma develops most often in the abdomen.

When neuroblastoma starts in the abdomen, it can develop in nerve cells in the adrenal glands or in the sympathetic collateral ganglia (clusters of nerve cells in the abdomen). Neuroblastoma can also start in the chain ganglia that run along the spine in the chest, neck or pelvis.

Neuroblastoma in the chest

Neuroblastoma in the chest can cause:

  • difficulty breathing
  • shortness of breath
  • cough
  • headaches
  • dizziness
  • superior vena cava syndrome (SVCS)

SVCS is often a life-threatening condition and needs to be treated right away. SVCS occurs when the tumour puts pressure on the superior vena cava (the large vein that carries blood from the head, neck, arms and chest to the heart). This group of symptoms includes coughing, difficulty breathing, headache, dizziness, fainting and swelling or flushing of the neck, face and upper arms. Find out more about superior vena cava syndrome.

Neuroblastoma in the neck

Neuroblastoma in the neck can cause:

  • a hard, painless lump in the neck
  • difficulty breathing
  • droopy eyelids
  • small pupils

Neuroblastoma in the abdomen or pelvis

Neuroblastoma in the abdomen or pelvis can cause:

  • a lump or swelling in the abdomen
  • loss of appetite
  • weight loss
  • a feeling of fullness in the abdomen (the child might say, “My tummy feels big”)
  • pain in the abdomen
  • constipation
  • trouble urinating
  • higher than normal blood pressure
  • nausea
  • vomiting
  • swelling in the groin or legs
  • swelling of the scrotum in boys

Neuroblastoma affecting the spinal cord

Neuroblastoma can sometimes affect the spinal cord and cause:

  • weakness in the legs
  • unsteady walking or stumbling
  • loss of bowel or bladder control
  • pain
  • paralysis
  • spinal cord compression

Spinal cord compression is a medical emergency that needs to be treated right away. It occurs when a tumour puts pressure on the spinal cord. The pressure may cause swelling and sometimes the blood supply to the spinal cord and nerves is affected. Spinal cord compression can lead to permanent paralysis if not treated early. Find out more about spinal cord compression.

Neuroblastoma that has spread

Many neuroblastomas have already spread (or metastasized) to other parts of the body when they are diagnosed. Neuroblastoma can cause different signs and symptoms depending on where it has spread:

  • enlarged lymph nodes can be a sign that it has spread to the lymph nodes
  • pain in bones or limping can be a sign that it has spread to the bones
  • dark circles around and bulging of the eyes (called raccoon eyes) can be a sign that it has spread to the bone of the eye sockets
  • fatigue, weakness, frequent infections, irritability, easy bruising and bleeding can be signs that it has spread to the bone marrow
  • a swollen abdomen and breathing problems can be a sign that it has spread to the liver
  • blue or purple bumps that look like small blueberries can be a sign that is has spread to the skin

Neuroblastoma that makes chemical substances

In some cases, neuroblastoma cells can make chemical substances called catecholamines that affect tissues and organs in other parts of the body. Neuroblastoma can cause several paraneoplastic syndromes. Symptoms of paraneoplastic syndromes include:

  • diarrhea
  • fever
  • high blood pressure
  • rapid heartbeat
  • flushing of the skin
  • sweating
  • jerky muscle movements
  • uncontrolled eye movements

paraneoplastic syndrome

A group of symptoms that occurs when substances released by cancer cells disrupt the normal function of nearby or distant organs or tissues.

For example, some types of lung cancer produce hormones that affect the function of the kidneys.


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