Massive Intra-Tumor Hemorrhage during Induction Chemotherapy in Neuroblastoma: A Case Series Report

We describe 5 children with high risk neuroblastoma (NB) who, during the induction phase of therapy, were admitted with circulatory shock because of massive intra-tumor bleeding. Patient's intensive supportive care with fluid resuscitation, blood and blood product's transfusion succeeded to restore hemodynamic stability. Surgical intervention to control bleeding was necessary in two of the children. All children survived the massive hemorrhage to continue their treatment as per protocol. Overall prognosis was not affected by this incident.