Symptoms of neuroblastoma
The most common symptom of neuroblastoma is a lump in the tummy (abdomen). This could make your child’s tummy swell, causing discomfort or pain. Some children may even get constipation.
Other symptoms depend on where the neuroblastoma starts in the body and whether it is just in one place (localised) or has spread to other parts of the body.
Some of these symptoms might include:
- numbness
- weakness
- loss of movement in the lower part of the body
- breathlessness
- difficulty swallowing
Symptoms when neuroblastoma has spread
In around half of children, the neuroblastoma has spread to another part of the body at diagnosis. The symptoms depend on where it has spread to and how big it is. The most common symptom is bone pain. But symptoms are often vague such as:
- tiredness
- fever (high temperatures)
- loss of appetite
Bones
This is the most common place for neuroblastoma to spread to. Symptoms include pain (sometimes with swelling over the bone) and difficulty in walking. Occasionally it can affect the bones of the spine causing:
- numbness
- weakness
- loss of movement in the lower part of the body
Bone marrow
Bone marrow is the spongy substance in the centre of the bones.
It contains early blood cells, called stem cells. These develop into the 3 different types of blood cell.
Neuroblastoma that spreads to the bone marrow might cause:
- tiredness and paleness due to a low red blood cell count (anaemia)
- bruising or bleeding due to a low platelet count (sometimes around the eyes)
- infections due to a low white blood cell count
Skin
Neuroblastoma that spreads to the skin can give it a blue black colour, as if it were bruised. Sometimes, there are small, raised, discoloured lumps. These can look like blueberries on the skin.
Liver
Spread to the liver might cause tummy swelling and pain. Babies might also have difficulty feeding because the liver has got bigger.
Catecholamines
Catecholamines (cat - a - coal - ay - means) are chemical messengers that send messages between nerve cells. The 
make these, one example is adrenaline.
Our bodies break them down into substances that we pass out in our urine. Neuroblastoma tumours often produce catecholamines in large amounts.
Your child’s doctor tests for this by looking at a blood or urine sample. It is very unusual for it to cause any symptoms. If the tumour produces very large amounts of catecholamines it can cause symptoms. These include:
- weight loss
- sweating
- redness of the skin (flushing) or paleness
- a fast heartbeat and increased blood pressure
- watery diarrhoea
Seeing your GP
Referral to a specialist
Your GP should refer your child to a specialist within 2 days if they have any of the following:
- a lump in the tummy (abdomen)
- an enlarged or swollen organ in the tummy
There are guidelines to help GPs know when to refer a child to a specialist. These guidelines are very clear. They say that the GP should take the parent or carers concern about their child into account when deciding about a specialist referral.
The first professional your child might see is a specialist children’s doctor. These doctors are called paediatricians. They might then go on to see a specialist children and young person’s cancer doctor. These doctors are called consultant paediatric oncologists. When you arrive at the hospital, you are likely to see another doctor in the specialist team, called a registrar.
What happens next
Ask your GP what happens next. Make another appointment if you notice any more changes, or you are still concerned.
Tests for neuroblastoma
Find out about the tests your child might have if their doctor suspects they have neuroblastoma.
