Abstract

Neuroblastoma is an aggressive pediatric malignancy that originates from neural crest cells, which are precursors to the sympathetic nervous system. Primarily affecting children under the age of five, it accounts for approximately 6% of all childhood cancers but causes a disproportionate 15% of pediatric cancer-related deaths. The tumor most commonly arises in the adrenal glands but can also develop in the neck, chest, or pelvis. The pathogenesis of neuroblastoma involves complex genetic and molecular mechanisms, including mutations in the ALK gene and MYCN amplification, both of which are associated with poor prognosis. While some cases present as localized disease with good outcomes, high-risk neuroblastoma frequently metastasizes, often to the bone marrow, liver, and lymph nodes, making it difficult to trea