• Can Huang, Shayi Jiang, Xuelian Liao, Yanhua Li, Shanshan Li, and Jingwei Yang.
• Department of Hematology and Oncology, Shanghai Children's Hospital, Shanghai Jiao Tong University, Shanghai, China.
• Medicine (Baltimore). 2020 Oct 2; 99 (40): e22505.

RationaleNeuroblastoma (NB) can occur in any part of the sympathetic nervous system, and it is highly heterogeneous. Tumors that only involve bone marrow and bone lesions without solid masses have rarely been reported.Patient ConcernsA 2-year-old girl child presented with recurrent fever, accompanied by pain in both lower limbs for more than 1 month.DiagnoseBone marrow examination revealed NB cell invasion. Femoral and multiple vertebral lesions were observed by MRI, while head MRI, chest CT, abdominal CT, and pelvic CT showed no solid mass.InterventionsThe child received the standard therapy for high-risk NB.OutcomesShe was sensitive to the initial chemotherapy protocol. Two years later, a bone marrow examination confirmed NB recurrence.LessonsThe prognosis of this special type of NB was not improved mainly based on common chemotherapy and local radiotherapy, and new treatment strategies should be explored.

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