Late Relapse in Neuroblastoma: Case Report and Review of the Literature

Neuroblastoma is the most common extra-cranial solid tumor in children. The survival rate of relapsed/refractory neuroblastoma is dismal. Late recurrence may occur rarely.We have, herein, presented a case with stage IV neuroblastoma who relapsed after 11 years and had a subsequent relapse after 15 years from the initial diagnosis, and reviewed cases with late relapsed (after >5 years) neuroblastoma in the literature. The case presented with recurrent disease at the T7 vertebra after 11 years from the initial diagnosis. The patient received surgery, chemotherapy, MIBG treatment, and antiGD2 combined with chemotherapy, and had a further local recurrence in the paravertebral area of the removed T7 vertebra after three years. The patient was operated, received anti-GD2 combined with chemotherapy, and is still alive with no symptoms for 19 months after the last relapse.There is not a well-established treatment regimen for the majority of these patients. MIBG treatment and antiGD2 combined with chemotherapy may be promising options for relapsed/ refractory neuroblastoma.