Incidence of Horner syndrome associated with neuroblastic disease
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ORIGINAL ARTICLE
Incidence of Horner syndrome associated with neuroblastic disease Katarzyna Kuchalska 1 & Monika Barełkowska 2 & Katarzyna Derwich 2 Anna Gotz-Więckowska 4
&
Katarzyna Jończyk-Potoczna 3 &
Received: 12 August 2020 / Accepted: 5 November 2020 # The Author(s) 2020
Abstract Purpose Horner syndrome (HS) manifests in unilateral ptosis, miosis, enophthalmos, and anhedonia. It is most commonly caused by trauma or surgical procedures, but can also occur in pediatric patients as a result of tumors, especially neuroblastoma (NBL). The objective of this study was to analyze the incidence of HS in patients diagnosed with NBL. Methods A retrospective analysis of data collected at the Department of Pediatric Oncology, Hematology, and Transplantology from 2004 to 2019 was performed. The study group included 119 patients younger than 18 years old, with 62 girls and 57 boys. All of them were diagnosed with a neuroblastic tumor. Results Among the 119 patients, eight children (6.72%) were diagnosed with HS associated with NBL. Three of these patients presented to the clinic with HS, whereas HS developed after the surgical procedure to remove the tumor in four patients. The adrenal gland was the most frequent localization of the tumor. However, HS occurred more frequently in patients with mediastinum tumors. As a presenting symptom, HS occurred in 2 of 11 cases (18.18%) with mediastinum localization. All of the patients with HS were younger than 2 years old. Conclusion Investigation of the cause of isolated HS is crucial because it can be the first symptom of NBL. However, the surgical procedure itself increases the risk of HS as a complication of NBL treatment. Keywords Neuroblastoma . Ganglioneuroblastoma . Miosis . Ptosis
Introduction Horner syndrome (HS) manifests in unilateral miosis, ptosis, enophthalmos, and anhidrosis. In general, it is caused by an interruption in the oculosympathetic tract (Fig. 1) [1]. Horner syndrome most frequently occurs in the first year of life and is often caused by trauma (65%). Congenital HS is more common than acquired HS (55% vs. 45%) [2].
* Katarzyna Kuchalska [email protected] 1
Karol Marcinkowski University of Medical Sciences, Poznań, Poland
2
Department of Oncology, Hematology and Transplantology, Karol Marcinkowski University of Medical Sciences, Poznań, Poland
3
Department of Paediatric Radiology, Poznań University of Medical Sciences, Poznań, Poland
4
Department of Ophthalmology, Karol Marcinkowski University of Medical Sciences, Poznań, Poland
Neuroblastoma (NBL) is a small blue round cell tumor in histopathology. These tumors most commonly occur in the first 12 months of life and are localized in the abdomen, especially the adrenal medulla. The International Staging System defines four stages within the 1, 2, and 4S for patients with localized tumors, which should be operated firstly. These patients have a good prognosis. In the group of patients with stage 4S NBL, children are younger than 12 months old, and metastases are generally limited to th
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