How is neuroblastoma diagnosed?
If your child needs tests to make or confirm a diagnosis of neuroblastoma, our team is available to you immediately. We will see your child within 24 hours of your call to MSK Kids.
When you arrive for your child’s appointment, we will perform a complete physical exam as well as do specialized tests to determine the cause of your child’s symptoms. If we diagnose neuroblastoma, some of these exams can also determine the extent of its growth and spread. We make sure your child is comfortable during these tests. They include:
CT scanning and MRI can show where in the body the tumors are located as well as their size and shape.
This scan is a form of nuclear medicine. The word “nuclear” may sound scary, but don’t worry — your child’s health is safe during this exam. Such tests are a routine part of care for many people with cancer. During this test, we inject metaiodobenzylguanidine (MIBG) into your child’s vein. This radioactive substance attaches to neuroblastoma cells. Twenty-four hours later, after the very small amount of radioactive medicine in the injection has had time to spread throughout the body, we do a scan. With this exam, we can see if the neuroblastoma has spread to other parts of your child’s body.
During a biopsy, we perform a minor surgical procedure to remove a tissue sample. A pathologist (a doctor who specializes in diagnosing disease) looks at the sample under a microscope to see if neuroblastoma or other cancer cells are present. We also test for specific abnormalities in neuroblastoma cells and look for a factor that predicts how aggressive the cancer is likely to be.
Neuroblastoma cells produce substances called HVA and VMA. People with neuroblastoma have high levels of HVA and VMA in their urine so we collect your child’s urine over the course of four to 24 hours to measure the levels of these chemicals.
If we need to determine if neuroblastoma has spread to your child’s bones, we may remove a sample of bone marrow (the spongy tissue and liquid inside the bones). The sample is typically removed through the hip bone and analyzed in a lab. We will make sure your child is comfortable throughout this procedure.