Cytogenetic and immunohistochemical analysis of an adult anaplastic neuroblastoma

Neuroblastomas in children are common tumors and are characterized by a number of recurrent cytogenetic and molecular changes. Adult neuroblastomas are rare, and their relationship to pediatric neuroblastomas is not clear. We report an anaplastic neuroblastoma presenting in a 28-year-old man. Histopathologic identification of the tumor as a neuroblastoma was problematic, and the initial diagnosis was poorly differentiated sarcoma. Tumor cells expressed immunoreactivity for tyrosine hydroxylase in addition to generic neuroendocrine markers, consistent with catecholamine-synthesizing ability. They also extended long, branching neurites in vitro. The tumor was positive for immunoreactive trkA. The karyotype after 6 days in culture was found to be 42,XY with multiple chromosomal abnormalities. The only abnormality shared with pediatric neuroblastomas was a rearrangement of chromosome 17q. Double minute chromosomes or homogeneously staining regions associated with N-myc amplification were not present. To our knowledge, this is the first reported karyotype of an adult neuroblastoma. The cytogenetic findings, together with expression of trkA, suggest that the tumor was more closely related to the favorable prognosis neuroblastomas of infancy than to the poor prognosis tumors that occur in older children, despite its unfavorable histology.