Sandbox: H
- General symptoms of meningioma include:
- Fatigue
- Loss of appetite
- However, the specific clinical presentation of meningioma is determined by the exact anatomical location of the tumor:
- Neuroblastomas located in the abdomen present may with:
- Abdominal distension
- Constipation
- Neurblasotmas located in the posterior mediastinum present may with:
- Dyspnea
- Cough
- Metastatic neurblasotma lesions located in the bone marrow may present with:
- Bone pain
- Limping
- Neurblasotmas located in the head and neck may present with:
- Facial bruising
- Facial swelling
The first symptoms of neuroblastoma are often vague and may include fatigue and loss of appetite. Later symptoms depend on tumor locations. In the abdomen, a tumor may cause a swollen belly and constipation. A tumor in the chest may cause breathing problems. Tumors pressing on the spinal cord cause a feeling of weakness. A tumor in the head may cause the eyes to start to swell outwards and turn black due to the pressure from behind. Often because symptoms are so unclear, half of all neuroblastomas have already spread (metastasized) to other parts of the body by the time suspicions are raised and a diagnosis is made.
The signs and symptoms of neuroblastoma can vary widely depending on where the disease first started and how much it has spread to other parts of the body. Usual symptoms include:
- Irritability, fatigue, loss of appetite, and fever in infant.
- A swollen stomach, abdominal pain, and decreased appetite in young child.
- Bone pain or soreness, black eyes, bruises, and pale skin
- Weakness, numbness, inability to move a body part, or difficulty walking
- Horner's syndrome: Drooping eyelid, unequal pupils, sweating, and red skin
- Difficulty breathing
The first symptoms of neuroblastoma are often vague making diagnosis difficult. Fatigue, loss of appetite, fever, and joint pain are common. Symptoms depend on primary tumor locations and metastases if present:[8]
In the abdomen, a tumor may cause a swollen belly and constipation. A tumor in the chest may cause breathing problems. A tumor pressing on the spinal cord may cause weakness and thus an inability to stand, crawl, or walk. Bone lesions in the legs and hips may cause pain and limping. A tumor in the bones around the eyes or orbits may cause distinct bruising and swelling. Infiltration of the bone marrow may cause pallor from anemia.
Neuroblastoma often spreads to other parts of the body before any symptoms are apparent and 50 to 60% of all neuroblastoma cases present with metastases.[9]
Rare but characteristic presentations include transverse myelopathy (tumor spinal cord compression, 5% of cases), treatment-resistant diarrhea (tumor vasoactive intestinal peptide secretion, 4% of cases), Horner's syndrome (cervical tumor, 2.4% of cases), opsoclonus myoclonus syndrome[11] and ataxia (suspected paraneoplastic cause, 1.3% of cases), and hypertension (catecholamine secretion or renal artery compression, 1.3% of cases).[12]
Clinical presentation is typically with pain or a palpable mass and abdominal distension, although numerous other presentations are encountered due to local mass effect.
Other accompanying syndromes include:
Hutchinson syndrome: bony metastases may present with skeletal pain or a palpable lump or limping and irritability due to skeletal metastases 2 Pepper syndrome: hepatomegaly due to extensive liver metastasis blueberry muffin syndrome: multiple cutaneous lesions opsomyoclonus 5: rapid, involuntary conjugate fast eye movements