We will need to carry out some tests to find out as much as possible about the type, position and size of the tumour. This will help us to decide on the best treatment for your child. These tests include:
- Urine and blood samples to show how well the kidneys are working, general health and the levels of tumour markers with in the urine
- Chest x-ray to show whether there is tumour in the chest
- Ultrasound scan to show the position and size of the tumour
- CT scan to provide more detailed information about the tumour
- Biopsy - a small operation, usually carried out under general anaesthetic. The surgeon will remove a small piece of tissue from the lump, which will help us to make a diagnosis. This is usually done at St George's Hospital.
- MIBG scan to show if the tumour has spread
- Bone marrow aspirate and trephine to see if the neuroblastoma has affected bone marrow
- Bone scan.
Staging
Staging is a measure of how far the tumour has spread beyond its original site. The following describes the staging system we use for neuroblastoma:
- Stage I - the tumour is localised with or without microscopic residual tumour after surgery
- Stage IIA - the tumour is localised but cannot be completely removed by surgery
- Stage IIB - the tumour is localised but has spread to local lymph nodes
- Stage III - the tumour crosses the midline, with or without local lymph nodes and cannot be removed surgically. There is localised tumour with lymph node involvement on the opposite side. There is midline tumour with lymph nodes on both sides.
- Stage IV - the tumour has spread to distant lymph nodes, bone marrow, bone, liver and/or other organs
- Stage IVS - the tumour is localised (stage I, IIA or IIB), with spread limited to liver, skin and/or bone marrow in an infant under one year of age.