Retroperitoneal Anaplastic Neuroblastoma in a 3-Year-Old Female: A Rare Case Report

Neuroblastoma is the most common extracranial solid tumor in childhood. In different classification of neuroblastomas, a subset of undifferentiated or poorly differentiated tumors with bizarre histological features has been mentioned. A 3-year-old girl presented with abdominal pain. Her haematological and biochemical parameters were normal except her urinary vanelylmandelic acid level was elevated five times the normal value (64.4 IU/ml). On computed tomographyscan, a retroperitoneal contrast-enhancing mass was visible around D12-D13 region (60×52×47mm). Sections of CT guided trucut biopsy revealed large cells with pleomorphic nuclei, abundant cytoplasm and occasional multinucleated giant cells. Immunohistochemistry showed the cells reactive for neuron specific enolase, chromogranin-A, synaptophysin, non-reactive for cytokeratin, desmin and glial fibrillary acid protein and Alk-1. A diagnosis of anaplastic neuroblastoma was made. The child is currently under chemotherapy and doing well.