Shen Chenling, Chen Jiarui, Wang Ying, Li Xiaoyan
Department of Otolaryngology Head and Neck Surgery，Shanghai Children's Hospital，School of Medicine，Shanghai Jiao Tong University，Shanghai，200062，China.
Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2025 Apr;39(4):344-350. doi: 10.13201/j.issn.2096-7993.2025.04.010.
To explore the clinical manifestations, diagnosis, treatment, pathological types and prognosis of primary cervical neuroblastoma in children. The clinical data of 11 children with primary cervical neuroblastoma admitted to the Department of Otolaryngology and Head and Neck Surgery at Shanghai Children's Hospital from April 2015 to April 2022 were retrospectively analyzed. The clinical characteristics, imaging findings, pathological types, treatment methods, and outcomes of these 11 patients were examined in conjunction with a review of the literature. The cohort of 11 neuroblastoma patients ranged in age from 28 days to 88 months （median age: 24 months）, including 3 males and 8 females. Among the 11 patients, 4 had tumors located in the carotid sheath area, 4 in the cervical space, and 3 in the parapharyngeal and retropharyngeal spaces. The clinical manifestations primarily included painless cervical masses and laryngeal stridor. There were 3 cases of primary cervical tumors with cervical lymph node metastasis and 1 case with bone marrow metastasis. Pathological findings revealed neuroblastoma in 8 cases and ganglionic neuroblastoma in 3 cases. In this group, 7 patients underwent surgery combined with chemotherapy, 2 patients received surgery combined with chemoradiotherapy, and 2 patients underwent surgery alone. Surgical resection was performed via a cervical approach in 7 cases, while 3 cases were treated using a transoral endoscopic approach. Additionally, one patient underwent a transoral endoscopic approach initially and a cervical approach subsequently. All patients completed their treatment and were followed up regularly, with follow-up durations ranging from 6 to 79 months （median: 34 months）. Nine patients achieved complete remission, 2 patients achieved partial remission, and none experienced disease progression. Primary cervical neuroblastoma exhibits a high degree of heterogeneity and presents at a younger age, primarily with cervical masses. Compared to external approaches, endoscopy-assisted transoral resection of parapharyngeal tumors offers advantages such as reduced damage to surrounding tissue and no visible neck scars, providing a new method for clinical treatment. Regular follow-up is essential for children with neuroblastoma, along with the establishment of specific disease management protocols and comprehensive care to improve survival quality.
探讨儿童原发性颈部神经母细胞瘤的临床表现、诊断、治疗、病理类型及预后。回顾性分析2015年4月至2022年4月在上海儿童医学中心耳鼻咽喉头颈外科收治的11例原发性颈部神经母细胞瘤患儿的临床资料。结合文献复习，对这11例患者的临床特征、影像学表现、病理类型、治疗方法及预后进行分析。11例神经母细胞瘤患者年龄范围为28天至88个月（中位年龄：24个月），其中男性3例，女性8例。11例患者中，4例肿瘤位于颈动脉鞘区，4例位于颈部间隙，3例位于咽旁和咽后间隙。临床表现主要为无痛性颈部肿块和喉喘鸣。3例原发性颈部肿瘤伴有颈部淋巴结转移，1例伴有骨髓转移。病理结果显示，8例为神经母细胞瘤，3例为神经节神经母细胞瘤。该组中，7例患者接受手术联合化疗，2例患者接受手术联合放化疗，2例患者仅接受手术。7例经颈部入路行手术切除，3例采用经口内镜手术治疗。此外，1例患者最初采用经口内镜手术，随后采用颈部入路。所有患者均完成治疗并定期随访，随访时间为6至79个月（中位时间：34个月）。9例患者达到完全缓解，2例患者达到部分缓解，无疾病进展。原发性颈部神经母细胞瘤具有高度异质性，发病年龄较小，主要表现为颈部肿块。与外部入路相比，内镜辅助经口切除咽旁肿瘤具有对周围组织损伤小、颈部无明显瘢痕等优点，为临床治疗提供了新方法。对神经母细胞瘤患儿进行定期随访至关重要，同时应制定特定的疾病管理方案并提供综合护理，以提高生存质量。
