Simultaneous occurrence of advanced neuroblastoma and acute myeloid leukemia

The authors report the case of a 4-year-old boy with a diagnosis of stage I V neuroblastoma (NB), who had been treated with 6 cycles of cyclophosphamid e, doxorubicin, cisplatin, and etoposide for 12 months. The patient reached partial remission and presented a diagnosis of acute myelomonocytic leukem ia (M4 AML), confirmed by immunophenotyping. After 2 months of therapy for leukemia, the child died with both malignancies in activity. A necropsy his tologically confirmed the simultaneity of the two diseases. The authors rev iew the possibilities of this association. The review leads to the conclusi on that AML can occur as a secondary malignancy after the onset of the neur oblastoma, or be suggested by a misdiagnosis. The simultaneous occurrence o f both as described here is not, however, found in the literature, to the b est of the authors' knowledge.