Presakralnye neuroblastoma occur in 10% of cases, usually occupy the pelvic cavity, slip forward and distort the bladder and rectum, and squeezed laterally displace the ureters. For peritoneal neuroblastoma most aggressive, often affects the surrounding organs and tissues, often metastasis – ruet in retroperitoneal lymph nodes and distant organs. In determining the prevalence BOAD – Inorganic bus tumors on the diaphragm, adrenal gland and the skeleton is most informative CT.
In determining the incidence of retroperitoneal neuroblastoma on the kidneys, retroperitoneal lymph nodes and great vessels diagnostic capabilities of CT angiography and equal. Angiography reveals successful defeat (in the form of direct ingrowth) liver, spleen, pancreas, mesentery, peritoneum.
Evaluating the effectiveness of the treatment of retroperitoneal neuroblastoma can be carried out according to repeated intravenous urography (normalization of the situation of the kidneys, ureters, bladder), ultrasound (increased echogenicity, size reduction), CT (an increase of calcination and seal tumor capsule). It should be noted that to overcome the difficulties of differential diagnosis of neuroblastoma all these studies helped localizations of catecholamines in the daily urine, the study of bone marrow, liver, radionuclide studies, the lymphatic system of the skeleton.
Besides presakralnoy neuroblastoma, primary and metastatic lesions of the pelvic ring, malignant lesions of the pelvis and perineum include urogenital neoplasms Inorganic and soft tissue tumors – mainly teratotstsnye, Germany – technogenic, rhabdomyosarcoma. Malignant teratogenic – idnye tumors account for 2-5% of all tumors in children, affect soft tissue sacrococcygeal region and presakralnoy (distinguish the outer, inner, and both sites), much less – ovary, vagina, testis. To verify the size, location, extent of tumor process, identify the most frequent metastases used radiography of the chest and pelvis (typical dense inclusions, changes sacro-cop – Pins spine).
Excretory urogra – angiography and ultrasonography of soft tissue sacrococcygeal and gluteal area, abdomen, retroperitoneum, pelvis (displacement and deformation of the bladder, secondary changes of the upper urinary tract due to violation of the outflow of urine, liver metastases, and retroperitoneal lymph nodes). To address the question of the possibility of surgical treatment are shown and CT angiography.