Long-term urological complications in survivors younger than 15 months of advanced stage abdominal neuroblastoma

Purpose: We evaluated the long-term urological complications in survivors o f infant advanced stage abdominal neuroblastoma. Materials and Methods: The records of patients who presented during an 8-ye ar period with surgical problems related to the kidney and who had survived advanced stage (IV and IV-S) neuroblastoma were reviewed. Results: Of 7 patients identified 3 had complications of obstruction from r etroperitoneal fibrosis and 4 had renal cell carcinoma. In the renal cell c arcinoma group 3 patients had synchronous, multifocal, bilateral tumors and I had a tumor in a solitary kidney. Pathological examination of renal cell carcinoma revealed oneocytoidy with solid and papillary patterns. One pati ent underwent bilateral nephrectomy but in the remaining 3 renal preservati on surgery was performed. All 7 patients have no progression of secondary c omplications 2 to 8 years after initial presentation. Conclusions: Survivors of advanced stage abdominal neuroblastoma may be pre disposed to long-term urological complications well after initial diagnosis . Because of the risk of renal damage from obstruction secondary to retrope ritoneal fibrosis, and the propensity to have renal cell carcinoma, close l ong-term followup using abdominal imaging is recommended.