RESUMO
To study stage IV-s congenital neuroblastoma in respect to their presentation, investigations, treatment and outcome. The records of 14 neonates with stage IV-s congenital neuroblastoma registered between 1986-1994 in the UK, were reviewed. The diagnosis was made by histological examination in nine neonates and elevated vanillylmandelic acid [VMA] and homovanillic acid [HVA] with ultrasonography [U/S] in the other five. Prenatal U/S diagnosis was done in two cases. Treatment varied from one center to another; chemotherapy in four cases, surgery in three, surgery plus chemotherapy one, radiotherapy one, and no treatment in five. The overall disease-free survival for 14 neonates was 93% at 104 months post diagnosis. One neonate died during the insertion of a central long line catheter. The follow up of 13 neonates showed no evidence of disease with no long-term sequelae of the disease or treatment. Neonates with stage IV-s congenital neuroblastoma have excellent prognosis compared to older children. Therefore, we need to adopt a new treatment strategy for this age group by doing some biological studies so as not to overtreat the good risk group, and to minimise the side effects of the treatment