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.