Gonadal metastases in neuroblastoma: A Sequel of prolonged chemotherapy?

Abstract

Background: A large majority of neuroblastoma continue to present with advanced disease with widespread dissemination. However, metastasis to the ovary or testis is infrequent with sparse literature even from the major neuroblastoma study groups. The aim of this study was to determine the group of patients in whom such a rare entity has occurred and evaluate any common factor and clinical implication. Materials and methods: We retrieved records of all patients with abdominal neuroblastoma operated from January 2008 to August 2013. We selected the cases with overt gonadal (ovarian or testicular) metastasis at presentation or relapse and noted the details. Results: Of the 186 cases of neuroblastoma four patients were having metastasis to the gonads (testis = 2, ovary = 2). All the four cases had extensive abdominal disease and received prolonged chemotherapy before the institution of local surgical treatment. Conclusion: Protracted chemotherapy without timely and adequate local treatment may contribute to the metastases seen in unusual sites such as the gonads. However, the therapeutic implication of identifying gonadal metastases is uncertain in patients already having disseminated disease.

Keywords

• Abdominal neuroblastoma
• Ovarian metastases
• Testicular metastasis
• Protracted chemotherapy