High-risk Neuroblastoma Predisposing to Osteomyelitis: A CaseStudy

Neuroblastomas are rare extracranial tumors of the pediatric population arising from cells of the embryological sympathetic nervous system. These malignancies most commonly occur in the abdomen, but other sites include the chest, neck, and pelvis with a predisposition for lymphatic and hematogenous spread. Metastasis to the bone is a poor prognostic indicator, requiring surgical excision and other extensive medical management. Staging, location, and histopathology of neuroblastomas are therefore important criteria that help stratify risk and direct treatment. We present a case report of a pediatric male with a history of metastatic neuroblastoma in remission for 3 years who was found to have a relapse of his malignancy in the bone. Further investigation yielded concomitant osteomyelitis at the recurrence site. This case illustrates the importance to evaluate for coexisting infectious processes in the setting of malignancy.