INTRODUCTION
Neuroblastoma (NB) is the most common malignancy of infancy.1 Spontaneous tumour regression is a well-recognised phenomenon in low-risk, favourable-biology cases.2 Complete regression may occur well after the first year of life.2,3
Several groups have demonstrated the safe use of a ‘wait-and-see’, observation-only strategy for low-risk infants with favourable biology.3–12 This approach avoids risks associated with unnecessary surgical and cytotoxic treatments, but no international consensus on definition or criteria for treatment exists. The approach has generally been limited to cases with small tumours (diameter < 50 mm at diagnosis) and active treatment generally started if a significant increase in tumour size or tumour markers were observed.5–12
We discuss a case of an infant with NB where an observation-only approach was successfully used despite a > 5 cm tumour diameter at diagnosis which tripled in size with a 10-fold increase in urinary catecholamines, before undergoing spontaneous tumour regression.