Diagnostic Strategies for Neuroblastoma in Children With Horner Syndrome: A Proposed Diagnostic Algorithm
Year: 2026
Type: article
Study design: Observational Study
Abstract: Neuroblastoma constitutes the most frequent solid tumor in children under 2 years of age. It is most often located in the abdomen; however, it may also be found in the mediastinum or the neck, and its first and only symptom may be Horner syndrome (HS). Because various imaging and laboratory examinations may be employed in order to detect the tumor, the objective of our study was to assess their sensitivity in detecting neuroblastoma in children with HS. The study comprised data from 14 oncologic departments in Poland and involved children with a clinical diagnosis of neuroblastoma. In total, 729 patients were included in the analysis who were diagnosed between 2004 and 2022. HS occurred before the neuroblastoma diagnosis in 3.29% of cases. The study evaluated the sensitivity of lactate dehydrogenase (LDH), ferritin and neuron-specific enolase (NSE) serum concentration, dopamine and vanillylmandelic acid urinary levels, as well as of chest radiography in the detection of neuroblastoma tumor. The combination of urinary catecholamines demonstrated a low sensitivity (72.57%). However, chest radiography proved to be highly effective in identifying lesions associated with neuroblastoma (92.31% sensitivity in patients with HS on the first presentation), which may be further enhanced by means of performing LDH, ferritin, and NSE blood concentration tests (100% sensitivity). Our findings indicate that chest radiography and serum laboratory tests may represent valuable tools in the primary diagnosis of HS etiology. In contrast, urinary catecholamines test should not be considered a diagnostic criterion.
Source: Journal of Child Neurology
Authors: Katarzyna Kuchalska, Anna Gotz-Więckowska, Walentyna Balwierz, Bartosz Urbański, Marek Ussowicz, Anna Tomoń, Anna Pytlik, Małgorzata Sawicka-Żukowska, Julia Geisler-Paliwoda, Danuta Januszkiewicz-Lewandowska, Szymon Janczar, Monika Pogorzała, Aleksandra Kiermasz, Szymon Skoczeń, Krzysztof Kałwak, Ninela Irga-Jaworska, Agnieszka Mizia-Malarz, Jan Styczyński, Katarzyna Drabko, Katarzyna Muszyńska-Rosłan, Katarzyna Machnik, Radosław Chaber, Tomasz Szczepański, Wanda Badowska, Bożenna Dembowska-Bagińska, Katarzyna Derwich
Institutions: Poznan University of Medical Sciences, Jagiellonian University, Medical University of Lodz, Wroclaw Medical University, Medical University of Lublin, Medical University of Białystok, Medical University of Silesia, Nicolaus Copernicus University, Gdańsk Medical University, University of Rzeszów, Children's Memorial Health Institute
Language: English
Subfield: Neurology
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W7140649357