I. Common symptoms Localized lesions are often asymptomatic, and such cases are often detected by ultrasound and radiographic imaging techniques during routine physical examinations, and in Japan mostly by targeted screening. If the local mass is large, corresponding compression symptoms may be present. The presence of anemia, fever, and pain in the extremities indicates possible bone marrow metastasis; periorbital bruising suggests intraorbital metastasis; stage 4S cases may present with abdominal bulging and dyspnea, which are caused by hepatomegaly due to tumor invasion of the liver; intra-abdominal tumor compression of renal vessels or intestine may cause renal dysfunction and intestinal obstruction; skin metastases are palpable nodules, some of which are blueberry-shaped. Rare but characteristic symptoms 1.Transverse paraplegia: neuroblastoma in the neck, chest or abdomen grows rapidly and will invade into the spinal canal through the intervertebral foramen and compress the spinal cord with corresponding neurological symptoms, and the masses are mostly dumbbell-shaped. 2. Oculoclonus-ataxia syndrome: dancing eyes, rapid irregular eye movements that may persist into sleep; dancing feet, limb ataxia and myoclonus; many patients are accompanied by delayed cognitive, motor, behavioral and language development. The pathogenesis is still unknown, but it is thought to be mediated by immune mechanisms, based on the presence of diffuse lymphocytic infiltration in the nests of these patients. Horner’s syndrome: disturbance of the sympathetic ganglia in the neck by neuroblastoma may result in Horner’s syndrome, which is characterized by unilateral facial anhidrosis, drooping eyelids, reduced pupils, intraocular sunkenness, and iris heterochromia. 4. Treatment-resistant diarrhea: Approximately 4% of patients have treatment-resistant diarrhea, which is characterized by hypokalemia and dehydration. It is caused by overproduction of vasoactive intestinal peptide (VIP) in mature neuroblastoma or mature ganglion cell neuroma, and is relieved by removal of the primary lesion. Hypertension: Some patients have hypertension, mainly due to tumor compression of renal artery, followed by renal ischemia and activation of renin-angiotensin system; secondly, tumor cells secrete vasoactive catecholamine metabolites (dopamine, epinephrine and norepinephrine). If drug therapy is ineffective and the primary focus cannot be removed, surgical freeing of the renal artery can be considered to relieve tumor compression and restore renal blood flow, thus reducing renal hypertension.