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Abstract: The child presented to the local hospital 14 days ago with stomach pain and was found to have an occupancy in the right adrenal region after appropriate examinations such as enhanced CT. After the child was admitted to the hospital, the tumor was completely removed by right adrenal tumor resection, and the adjacent lymph nodes were cleared together.
Basic information】Female, 12 years old
Type of disease】Adrenal neuroblastoma
Hospital】The First Affiliated Hospital of Zhejiang University School of Medicine
Date of consultation】January 2019
Treatment plan】Surgical treatment (right adrenal tumor resection)
Treatment period】7 days of inpatient treatment and long-term outpatient follow-up
Effectiveness】No recurrence of tumor in the postoperative review
I. Initial consultation
The child came to our outpatient clinic because the right adrenal region was found to be occupied. The child came to the local hospital 14 days ago with stomach pain and was found to have an occupancy in the right adrenal region. The outpatient physician reviewed the local CT report of the child, which showed a large right adrenal area with a size of about 10 cm.
II. Treatment
After admission, an enhanced CT examination of the kidney abdomen was arranged. The CT suggested a lobulated soft tissue mass in the right adrenal region, with a large cross-section of about 6.4 cm×6.2 cm, and the density of the lesion was not uniform. The right adrenal gland was considered to be a huge occupancy, and the child was then arranged to undergo right adrenal tumor resection. The tumor was completely removed and the adjacent lymph nodes were cleared together.
Treatment effect
The operation of the child was successful and the tumor was completely removed. Postoperative pathology reported right adrenal neuroblastoma (mixed type) with lymph node involvement (between the aortic vena cava). The child was bedridden for 1 day after surgery, and started to move around in bed on the second day after surgery, and recovered well after surgery. The drainage tube and urinary catheter were removed on the third postoperative day, and the child was discharged from the hospital on the sixth postoperative day. The tumor was well controlled and there was no local recurrence at 3 months after the operation.
IV. Notes
We are glad that the child’s symptoms have improved after treatment, but we should still remind the child of the need to pay attention to some matters after surgery, including dietary regulation and regular review.
1. Dietary regulation: fresh and healthy food should be the mainstay, and unfresh food such as pickled food, waxy food and smoked food should be eaten sparingly or not.
2, regular review: remind the children need to be reviewed every 3 months for 2 years after surgery, every 6 months for 2-5 years after surgery, and once a year for 5 years after surgery, including adrenal ultrasound, etc. In addition, children need to have annual health checkups.
V. Personal insight
Although adrenal neuroblastoma is relatively rare, parents should not take it lightly because it occurs in children and adolescents, who are often the dead center of health checkups, and most of the children are found because the tumor is huge, either on its own or because of symptoms caused by compression of surrounding organs and tissues. In conclusion, by understanding the situation of the child in this case, other children should be reminded to seek medical attention when they have similar symptoms so as not to delay the condition.