The Cribsiders S7 Ep164: Notes on Neuroblastoma
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Jan 14, 2026 Dr. Brittany Greene, a pediatric oncologist and bioethicist at Seattle Children's Hospital, dives into the complexities of neuroblastoma in a captivating discussion. She shares insights on early symptoms like periorbital bruising and the importance of differentiating between various abdominal masses. Brittany discusses the significance of staging and the nuanced treatment strategies based on risk groups. She also highlights disparities in outcomes and emphasizes the value of effective communication with families. A must-listen for anyone in pediatric care!
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NICU Experience Changed Her Communication
- Brittany Greene shared that having twins in the NICU surprised her emotionally and changed how she communicates with families.
- That experience made her value communication from all team members, not just physicians.
Initial ED Workup For Pediatric Abdominal Mass
- When evaluating a child with an abdominal mass, order imaging (US then CT chest/abdomen/pelvis) and labs including CBC, LDH, uric acid, and catecholamines (VMA/HVA).
- Also send AFP and beta-hCG if imaging is unclear, and check blood pressure and urinalysis to assess for Wilms tumor.
Why MIBG And Bilateral Marrows Matter
- MIBG scanning identifies neuroblastoma metastatic sites because the radiolabeled agent lights up tumor tissue.
- Bilateral bone marrow biopsies are needed because marrow metastases are patchy and can be missed on one side.