Radiology, Vol 180, 493-495, Copyright © 1991 by Radiological Society of North America
Renal atrophy or infarction in children with neuroblastoma
DL Day, RT Johnson, GT Odrezin, WG Woods and BA Alford
Department of Radiology, University of Minnesota Hospital, Minneapolis 55455.
Twelve children with adrenal or upper abdominal paraaortic neuroblastoma
developed unilateral or bilateral renal atrophy or infarction. At
presentation, the children ranged in age from 2 weeks to 9.7 years.
Neuroblastomas were stage II (n = 1), III (n = 2), IV-S (n = 2), and IV (n
= 7). Treatment varied but included surgery, chemotherapy, localized
abdominal irradiation, and/or bone marrow transplantation. Six children
developed ipsilateral renal atrophy, five experienced ipsilateral or
bilateral acute perioperative renal infarction, and one developed
contralateral renal infarction unrelated to surgery. During treatment, two
patients required hemodialysis; both subsequently died. Creatinine
concentrations in eight patients have been in the normal range. Two
patients have had mildly but persistently elevated creatinine levels. Renal
damage from primary effects of the tumor can develop in children with
adrenal or upper abdominal neuroblastoma. Treatment, especially surgical
resection of the primary tumor, chemotherapy, and radiation therapy, can
compound such damage.
