Management
On admission, a CT head was conducted to evaluate peri-orbital bruising. With the concerning results, an abdominal ultrasound scan and oncology consult were requested. Further investigations confirmed a diagnosis of stage 4, high-risk neuroblastoma was confirmed. An infusaport was inserted and chemotherapy commenced.
He was planned for 5 cycles of induction chemotherapy, with resection of the surgical resection of the primary tumor after cycle 4. Following cycle 2 peripheral stem cell harvest was planned to allow autologous stem cell rescue during the radiotherapy and consolidation phase. He had a prolonged initial inpatient stay due to social concerns. His mother was absent and un-contactable for days at a time, including at times consent was required for treatment. Therefore, in the early days, the treatment and monitoring of the child’s progression had faced some difficulties. We had tried to contact the child’s grandmother to follow up with the treatment.