Pediatr Emerg Med J.  2016 Dec;3(2):59-64. 10.22470/pemj.2016.3.2.59.

Neuroblastoma in a 3-year-old boy presenting with pain in the bilateral hip and abdomen

• Kwon JH
• Kim JH
• Song IH
• Ryu JM

• KMID: 2368378
• DOI: http://doi.org/10.22470/pemj.2016.3.2.59

Abstract

A 3-year-old boy presented to our emergency department with a 3-week history of pain in the bilateral hip and abdomen that had persisted through antibiotic therapy based on diagnosis of acute osteomyelitis. At presentation, he had fever, anemia, and increased concentration of lactate dehydrogenase. After the identification of a left adrenal mass indicating neuroblastoma on computed tomography scan, he was admitted to the hospital by a pediatric oncologist. Subsequently, positron emission tomography and bone scintigraphy showed disseminated metastasis to the bone and bone marrow, and neuroblastoma was pathologically confirmed. This case highlights the importance of differential diagnosis of non-traumatic hip pain in toddlers considering the protean manifestations of neuroblastoma.

Keyword

Child; Diagnosis, Differential; Emergencies; Hip; Neuroblastoma; Pain

MeSH Terms

Abdomen*
Anemia
Bone Marrow
Child
Child, Preschool*
Diagnosis
Diagnosis, Differential
Emergencies
Emergency Service, Hospital
Fever
Hip*
Humans
L-Lactate Dehydrogenase
Male*
Neoplasm Metastasis
Neuroblastoma*
Osteomyelitis
Positron-Emission Tomography
Radionuclide Imaging
L-Lactate Dehydrogenase