Death from progression following spontaneous regression of infantile neuroblastoma.

A case of neuroblastoma in an infant who showed evidence of spontaneous incomplete regression and subsequent relapse is reported. Interpretation of this patient's course is that the patient's tumor was heterogeneous in terms of cell compartments with susceptibility to spontaneous lysis. It is assumed that later activation of a cell compartment with uncontrollable proliferation occurred. Problems of assigning risk to infants like this include the need to have better biochemical or biological markers which will distinguish those infants who will have progressive disease, or will temporarily remit and then relapse from those who will spontaneously and permanently remit. Until appropriate risk assignment and early diagnosis of tumor recurrence are available, infants with disseminated neuroblastoma should receive limited treatment with chemotherapy or radiation at least until tumor regression is documented.