Stage 4S neuroblastoma, a disseminated tumor with excellent outcome

Objective: To review the clinical features and outcome of all cases of stage 4S neuroblastoma treated at our center. Methods: We retrospectively reviewed the files of all patients (n=75) with neuroblastoma treated at King Abdul-Aziz Medical City, Jeddah, Kingdom of Saudi Arabia between 1986 and 2005. We studied the clinical features and outcome of patients with stage 4S neuroblastoma. Results: Six patients (8%) were confirmed to have stage 4S neuroblastoma. Three were boys with a median age at diagnosis of 4.5 months (range 28 days - 11 months). Four patients required no intervention. The remaining 2 patients were treated with chemotherapy due to progressive hepatomegaly and respiratory distress. No patient required radiotherapy or surgical intervention. With a median follow up of 4 years (range 9 months - 15.5 years), all patients are alive and well. Two patients continue to have a residual abdominal mass, while complete resolution occurred in the others. Conclusions: Stage 4S neuroblastoma is a special tumor that carries excellent prognosis. Spontaneous regression may occur and intervention is only required in symptomatic patients.