What is the most common intra-abdominal solid tumor in children?

Most Common Intra-Abdominal Solid Tumor in Children

The most common intra-abdominal solid tumor in children is neuroblastoma (answer b). 1, 2, 3, 4

Epidemiology and Characteristics of Neuroblastoma

• Neuroblastoma is the most common extracranial solid tumor diagnosed in children according to the National Comprehensive Cancer Network (NCCN) Guidelines 1
• It accounts for approximately 29.6% of all intra-abdominal tumors in children, making it the most frequent intra-abdominal solid tumor in the pediatric population 4
• Neuroblastoma is an aggressive embryonal malignancy of neural crest origin with a peak age of onset of 22 months 2
• It represents approximately 11% of all pediatric cancers and 15% of all pediatric cancer deaths 2
• Approximately 70% of neuroblastomas are found in the abdomen, making it the most common site of presentation 3

Clinical Presentation

• The most common clinical presentation is an abdominal mass, though patients may present with various symptoms due to metastatic disease or paraneoplastic syndromes 5
• Common symptoms attributable to hepatic metastasis include abdominal enlargement, abdominal pain, respiratory difficulty due to upward pressure on the diaphragm, and obstruction of the inferior vena cava 6
• Approximately 70% of patients have metastases at the time of diagnosis 3

Comparison with Other Common Intra-Abdominal Tumors

• Wilms' tumor (nephroblastoma) is the second most common intra-abdominal tumor in children, accounting for approximately 25.1% of cases 4
• Other common intra-abdominal tumors in children include:
  • Non-Hodgkin lymphomas (15.5%) 4
  • Germ cell tumors (9%) 4
  • Hepatoblastoma (9%) 4
  • Rhabdomyosarcoma (4.4%) 4

Age Distribution

• The majority of intra-abdominal tumors (77.2%) occur in children under 5 years of age 4
• Neuroblastoma specifically has a peak incidence in infancy and early childhood 2
• In children with neuroblastoma, survival is best in those under one year of age 3

Treatment Considerations

• Current treatment protocols for neuroblastoma include high-dose chemotherapy with autologous stem cell transplantation, radiation, and surgery 2
• Surgical removal of the tumor is still the primary therapy, with radiation offering significant benefit in patients with stage III disease 3
• Despite advances in treatment, long-term survival rates (>5 years) remain below 50% for high-risk patients 2