Good Evolution of Stage IV Neuroblastoma in the Absence of Stem Cell Autograft

Abstract

Neuroblastoma is a relatively common pediatric pathology of the sympathetic nervous system. The particularity of neuroblastoma lies in its development from cells whose embryological maturation into adult sympathetic nerve cells or chromaffin cells is incomplete. In the literature, many cases of spontaneous regression of neuroblastoma have been reported, but the mechanisms for which they are responsible remain ambiguous. The specificity of our case is the benign evolution of an osteomedullary stage 4 neuroblastoma and its maturation into a ganglioneuroma 6 years after the end of chemotherapy. This transformation depends on various factors related to the tumor (such as the over expression or not of N-myc, the presence or absence of Treks and their receptors), the host (the intervention of the immune system) and to other external factors. Being able to induce this differentiation by not leaving it to chance would be a therapeutic challage and could categorically change the prognosis of neuroblastomas. This merits a lot of research and studies of various potential future treatments (such as treks inhibitors and retinoid).