Neuroblastoma: Causes, Symptoms, and Treatment
Medically reviewed by Harsha Moole, MD, Internal Medicine. Last reviewed: October 23, 2026.
What kind of doctor treats Neuroblastoma?
A pediatric oncologist, a doctor who treats cancer in children, usually leads care for neuroblastoma. A pediatric surgeon, a surgeon who operates on children, may remove the tumor. A direct primary care or concierge doctor can be a first stop for an evaluation and can refer you to a specialist when needed.
What is neuroblastoma?
Neuroblastoma is a type of cancer that most often affects children. It starts when immature nerve cells called neuroblasts become abnormal and multiply out of control. They form a tumor.
Most often, the tumor starts in the nerve tissue of the adrenal gland, which sits above each kidney. Other common places are the nerve tissue in the abdomen, chest, neck, or pelvis. Neuroblastoma can spread to other parts of the body, such as the bones, liver, or skin. It occurs most often in children before age 5 and rarely occurs in adults. It is the most common cancer in infants younger than 1 year.
Symptoms
The first symptoms are usually fever, a general sick feeling, and pain. A child may also lose appetite or weight, or have diarrhea. Other signs depend on where the tumor is and where it has spread:
- A tumor in the abdomen can cause swelling of the belly.
- A tumor in the chest may cause difficulty breathing. A long-lasting cough can happen if the cancer has spread to the chest.
- A tumor in the neck can cause Horner syndrome, a nerve problem with drooping eyelids, small pupils, less sweating, and red skin.
- Spread to the bones can cause bone pain, bruises, pale skin, or dark circles around the eyes.
- A tumor in the backbone can press on the spinal cord and cause weakness, numbness, or paralysis in the arms or legs.
- A rash of bluish or purplish bumps that look like blueberries means the cancer has spread to the skin.
- Hormones from the tumor may cause high blood pressure, a rapid heartbeat, flushing of the skin, and sweating.
In rare cases, a child has uncontrolled eye movements and jerky muscle movements. This is called opsoclonus-myoclonus syndrome, or "dancing eyes and dancing feet."
Causes and who gets it
The cause of the tumor is not known. Experts believe that a change in a gene may play a role. Most people with neuroblastoma have gene changes that happened during life and were not inherited. About 1 to 2 percent of affected people have a familial form, which can be passed down from a parent. Changes in the ALK and PHOX2B genes have been shown to raise the risk.
How doctors diagnose it
Your child's provider will do an exam. There may be a lump in the abdomen, an enlarged liver, or swollen lymph nodes. Imaging tests find the main tumor and show where it has spread. These include a bone scan, bone x-rays, a chest x-ray, and CT or MRI scans of the chest and abdomen.
Other tests may include:
- A biopsy of the tumor, which removes a small piece of tissue to look at.
- A bone marrow biopsy.
- A complete blood count (CBC), a blood test that can show anemia or other problems.
- Blood tests for hormones, such as catecholamines.
- A 24-hour urine test for catecholamines and the chemicals HVA and VMA.
- An MIBG scan, an imaging test that confirms neuroblastoma.
Treatment
Treatment depends on where the tumor is, how much and where it has spread, and the child's age. The National Cancer Institute says options depend on the risk category. They may include surgery, chemotherapy, radiation therapy, stem cell transplant, and targeted therapy.
In certain cases, surgery alone is enough. Often, other therapies are needed too. Chemotherapy (anticancer medicines) may be recommended if the tumor has spread. Radiation therapy may also be used. High-dose chemotherapy, autologous stem cell transplantation, and immunotherapy are also used.
Cancer treatment can cause late effects, which show up months or years after treatment. Children treated for neuroblastoma may be at risk of getting a second, different cancer later.
When to see a doctor
Contact your child's provider if your child has symptoms of neuroblastoma. Early diagnosis and treatment improves the chance of a good outcome.
Call 911 or go to the emergency room if your child has severe trouble breathing, a bluish or grey skin color, unconsciousness, a seizure, a big change in mental status such as confusion, or if your child cannot stand or walk.
How a direct primary care or concierge doctor fits in
A direct primary care doctor charges a flat monthly fee instead of billing insurance, while a concierge doctor usually charges more and often works alongside insurance. Either kind of doctor can examine a child with worrying symptoms, arrange first tests, and help coordinate care with the cancer team.
Common questions
Is neuroblastoma common?
No, it is very rare. It is a very rare type of cancerous tumor that develops from nerve tissue, and it usually occurs in infants and children.
Can neuroblastoma go away on its own?
Sometimes, in very young children. The tumor may go away without treatment, or it may mature into a non-cancerous tumor called a ganglioneuroma, which can be removed with surgery.
Is neuroblastoma inherited?
Usually not. Most people with neuroblastoma have gene changes that were not inherited. About 1 to 2 percent of affected people have the familial form, which can run in families.
What is the outlook for neuroblastoma?
The outlook varies. Treatment is often successful if the cancer has not spread. If it has spread, neuroblastoma is harder to cure. Younger children often do better than older children.
Sources
- MedlinePlus - Neuroblastoma
- MedlinePlus Genetics - Neuroblastoma
- National Cancer Institute - Neuroblastoma Patient Version
Medical Disclaimer
This content is for general educational and informational purposes only and is not medical advice. It is not a substitute for professional medical advice, diagnosis, or treatment, and reading it does not create a doctor-patient relationship. Always seek the advice of your physician or another qualified health provider with any questions about a medical condition, and never disregard or delay seeking professional advice because of something you read here. If you think you may have a medical emergency, call 911 (or your local emergency number) immediately.
