Neuroblastoma is a type of cancer that originates in a very early form of nerve cells that grows during fetal and embryonic development, called neuroblasts. Symptoms of the condition vary depending on several factors including:

• Size of the tumour
• Site or location of the tumour
• How rapidly growing (aggressive) the tumor is
• Age of the child
• Extent of spread to other parts of the body outside of the tumor
• Possible release of hormones from the tumor

Overall, symptoms of neuroblastoma tumours include:

Unexplained weight loss, loss of appetite, abdominal pain, bloating, diarrhea or constipation. Some children may develop prominent and swollen lymph nodes.

The most common symptom is the presence of an abnormal lump or mass felt under the skin, usually in the abdominal area.

If the tumor has spread to the lymph nodes, they may be swollen and painful when touched.

If a tumor swells and presses against or clogs lymph and blood vessels, fluids are prevented from returning to the heart which can cause swelling in other areas of the body aside from those affected by the cancer.

A tumor in the chest could press against the vena cava preventing the usual return of blood to the heart from the head and neck, which may then become swollen. Headache and dizziness may also occur.The lump may also press upon the bladder leading to problems with urination, diarrhea or constipation.

Neck or chest lumps can also obstruct the trachea or windpipe leading to difficulty in breathing, choking, coughing and swallowing.

If a tumor in the chest or neck presses on a nerve, it may cause symptoms in other areas such as a drooping eyelid or constricted pupils. If nerves in the spine are pressed, there may be reduced sensation in the arms or legs.

Neuroblastoma often involves the bones and spread to the spine may lead to a child refusing to walk. Spread to the bones around the eyes can cause them to protrude slightly and there may be bruising around the eyes. Involvement of other bones in the scalp may cause bumps under the skin of the scalp.

Spread of the cancer to the bone marrow leads to low levels of red blood cells, white blood cells and blood platelets. This can cause symptoms such as fatigue, irritability, infection and excess bruising or bleeding on minor injury such as a scrape.

The tumors seen in neuroblastoma can produce hormones that affect distant tissues and organs. This is called paraneoplastic syndrome. This may lead to fever, diarrhea, high blood pressure, flushing of the skin, rapid heartbeat and increased sweating.