Neuroblastoma Signs in Babies
Content reviewed against published NIH, Mayo Clinic guidelines
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If your baby has been diagnosed with or you suspect neuroblastoma signs in babies, here is what the evidence says.
The short answer
Neuroblastoma is the most common cancer in infants, accounting for about 6-10% of all childhood cancers. It develops from immature nerve cells and most commonly appears as a mass in the abdomen (adrenal gland), chest, neck, or pelvis. About 90% of cases are diagnosed before age 5, with a median age of diagnosis around 18 months. Babies under 1 year have the best prognosis, with many low-risk tumors even regressing on their own without treatment.
Key takeaways
- Neuroblastoma is the most common cancer in infants, accounting for about 6-10% of all childhood cancers. It develops from immature nerve cells and most commonly appears as a mass in the abdomen (adrenal gland), chest, neck, or pelvis. About 90% of cases are diagnosed before age 5, with a median age of diagnosis around 18 months. Babies under 1 year have the best prognosis, with many low-risk tumors even regressing on their own without treatment.
- Usually normal when: Your baby was evaluated for a mass and it was found to be benign (such as a normal lymph node or cyst)
- Call your doctor if: Your baby has a rapidly growing abdominal mass with poor feeding, vomiting, or signs of distress
- Varies by age — see the age-by-age breakdown below
“Fever itself is not an illness — rather, it is a sign or symptom that the body is fighting an infection. Fever stimulates certain defenses, such as the white blood cells, which attack and destroy invading bacteria.”
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By Age
What to expect by age
0-3 months
Neuroblastoma in very young infants may be found incidentally on prenatal ultrasound or during evaluation for another concern. A baby may have a palpable abdominal mass, a firm lump in the neck, or skin nodules that appear as blue-purple "blueberry muffin" spots. In some cases, the tumor is detected because of compression symptoms — difficulty breathing if in the chest, or constipation and urinary issues if in the pelvis. Babies diagnosed under 1 year often have very favorable outcomes.
3-6 months
Signs may include a firm, nontender mass in the abdomen that a parent or doctor feels during a routine exam, protruding eyes (proptosis) with dark circles ("raccoon eyes") if the tumor has spread to the area around the eyes, and general symptoms like irritability and poor feeding. A special form called 4S neuroblastoma occurs in infants under 12 months and may actually spontaneously regress without treatment.
6-12 months
Neuroblastoma may present with an enlarging abdominal mass, fever of unknown origin, bone pain (causing irritability and limping or refusing to bear weight), and sometimes watery diarrhea. Diagnosis involves imaging (ultrasound, CT, MIBG scan), urine tests for catecholamines (VMA/HMA), and biopsy. Babies under 1 year with neuroblastoma generally have the best prognosis among all age groups.
12 months+
Neuroblastoma diagnosed after age 1 tends to be more aggressive and may require more intensive treatment including chemotherapy, surgery, radiation, and immunotherapy. However, treatment advances have significantly improved survival rates. Low-risk and intermediate-risk neuroblastomas have survival rates above 90%. Even high-risk neuroblastoma has seen improving outcomes with modern multimodal therapy.
What Should You Do?
When to take action
- Your baby was evaluated for a mass and it was found to be benign (such as a normal lymph node or cyst)
- Your baby has small "stork bite" birthmarks or typical newborn skin findings, not blueberry muffin lesions
- Your baby's abdominal exam is normal and soft at well-child visits
- Your baby is growing well, active, and has no unexplained masses or symptoms
- You feel a firm lump or mass in your baby's abdomen, neck, or anywhere on the body
- Your baby has unexplained dark circles around the eyes or protruding eyes
- Your baby has unusual firm blue or purple skin nodules
- Your baby has a rapidly growing abdominal mass with poor feeding, vomiting, or signs of distress
- Your baby has sudden weakness in the legs, difficulty walking, or changes in bladder or bowel function — a spinal tumor may be compressing the spinal cord
Doctor Visit Checklist
Bring this checklist to your next pediatrician visit to discuss Neuroblastoma Signs in Babies.
Things to mention
- You feel a firm lump or mass in your baby's abdomen, neck, or anywhere on the body
- Your baby has unexplained dark circles around the eyes or protruding eyes
- Your baby has unusual firm blue or purple skin nodules
Observations to share
- You feel a firm lump or mass in your baby's abdomen, neck, or anywhere on the body
- Your baby has unexplained dark circles around the eyes or protruding eyes
- Your baby has unusual firm blue or purple skin nodules
Urgent signs to report immediately
- Your baby has a rapidly growing abdominal mass with poor feeding, vomiting, or signs of distress
- Your baby has sudden weakness in the legs, difficulty walking, or changes in bladder or bowel function — a spinal tumor may be compressing the spinal cord
My notes
From ismybabyalright.com — free, evidence-based baby health guides
Related Resources
Frequently asked questions
Is neuroblastoma signs in babies normal?
When should I call the doctor about neuroblastoma signs in babies?
When is neuroblastoma signs in babies normal?
What causes neuroblastoma signs in babies?
What should I mention to my pediatrician about neuroblastoma signs in babies?
Is neuroblastoma signs in babies normal at 0-3 months?
Is neuroblastoma signs in babies normal at 3-6 months?
Should I go to the ER for neuroblastoma signs in babies?
Does neuroblastoma signs in babies go away on its own?
References
- [1]National Cancer Institute. Neuroblastoma Treatment (PDQ) — Patient Version. NCI, 2024. NIH
- [2]Mayo Clinic. Neuroblastoma — Symptoms and Causes. Mayo Foundation for Medical Education and Research, 2023. Mayo Clinic
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Bottom line
Most cases of neuroblastoma signs in babies are normal. Talk to your pediatrician if your baby has a rapidly growing abdominal mass with poor feeding, vomiting, or signs of distress.
Trust your instincts. If something feels wrong, reach out to your pediatrician. Worrying about your baby means you care — that is a good thing.
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