Holsten Till, Schuster Tobias, Grabhorn Enke, Hero Barbara, Frühwald Michael C
a Research Institute, Children's Cancer Center Hamburg , Hamburg , Germany.
b Department of Pediatric Surgery and Urology , Children's Hospital Augsburg , Augsburg , Germany.
Pediatr Hematol Oncol. 2017 Feb;34(1):17-23. doi: 10.1080/08880018.2016.1266535. Epub 2017 Jan 13.
Neuroblastoma (NBL) stage 4s is an incompletely understood phenomenon with variable clinical course. While the majority of patients may undergo spontaneous regression and achieve complete resolution without intensive therapy, a small proportion is at increased risk of developing secondary complications. One such situation is liver insufficiency due to diffuse metastases. We report a patient suffering from NBL 4S who required double lifesaving liver transplantation. Abdominal and respiratory complications due to hepatomegaly are crucial determinants for treatment intensity and duration in 4S NBL [1,2] . We provide an algorithm in order to facilitate the clinical decision when dealing with similar potentially life-threatening events.
4S期神经母细胞瘤（NBL）是一种临床病程多变、尚未完全明确的现象。虽然大多数患者可能会自发消退且无需强化治疗即可完全缓解，但一小部分患者发生继发性并发症的风险增加。其中一种情况是由于弥漫性转移导致的肝功能不全。我们报告了一名患有4S期NBL的患者，他需要进行两次挽救生命的肝移植。肝肿大引起的腹部和呼吸并发症是4S期NBL治疗强度和持续时间的关键决定因素[1,2]。我们提供一种算法，以便在处理类似的潜在危及生命的事件时促进临床决策。
