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Case Reports in Pediatrics
Volume 2017 (2017), Article ID 5375091, 5 pages
https://doi.org/10.1155/2017/5375091
Case Report

High-Risk Neuroblastoma with Metastases to Bilateral Kidneys at Diagnosis

1Department of Pediatrics, Faculty of Medical Sciences, University of Fukui, 23-3 Matsuokashimoaizuki, Eiheiji-cho, Yoshida-gun, Fukui 910-1193, Japan
2Department of Human Resource Development for Cancer, Faculty of Medical Sciences, University of Fukui, 23-3 Matsu-okashimoaizuki, Eiheiji-cho, Yoshida-gun, Fukui 910-1193, Japan
3Department of Pediatrics, Japanese Red Cross Fukui Hospital, 2-4-1 Tsukimi, Fukui 918-8011, Japan
4Department of Tumor Pathology, Faculty of Medical Sciences, University of Fukui, 23-3 Matsuokashimoaizuki, Eiheiji-cho, Yoshida-gun, Fukui 910-1193, Japan
5Division of Surgical Pathology, University of Fukui Hospital, 23-3 Matsuokashimoaizuki, Eiheiji-cho, Yoshida-gun, Fukui 910-1193, Japan

Correspondence should be addressed to Toshihide Yoshikawa

Received 25 January 2017; Revised 28 February 2017; Accepted 21 March 2017; Published 30 March 2017

Academic Editor: Denis A. Cozzi

Copyright © 2017 Toshihide Yoshikawa et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Renal metastasis at diagnosis with neuroblastoma is rare. We present a 14-month-old boy who was diagnosed with high-risk neuroblastoma with multiple metastases, including bilateral kidneys. He received five cycles of induction chemotherapy and high-dose chemotherapy with autologous peripheral blood stem cell transplantation. All of the lesions shrank, and magnetic resonance imaging indicated that some of the metastases had disappeared. However, there were residual masses in the bilateral kidneys, and histological examination revealed the presence of tumor cells. Therefore, the patient underwent unrelated cord blood stem cell transplantation, which involved killer-ligand incompatibility in the graft-versus-host direction, in addition to human leukocyte antigen C and DRB1 mismatches. Three months later, tumor progression occurred from the residual mass in the sacral canal and a new lesion in the pancreas. Although tumor progression could not be controlled by additional chemotherapy and local radiotherapy, the metastatic nodules in bilateral kidneys did not increase in size before his death. To the best of our knowledge, this is the first report of neuroblastoma with bilateral renal metastases in the English medical literature. In addition, this case suggests that the combination of chemotherapy and immunotherapy may inhibit the progression of the renal lesions under certain conditions.