neuroblastoma is an aggressive cancer of immature neuroblastic cells (precursors of neurons), and is one of the most common pediatric cancers, with a median age at diagnosis of two years. adrenal neuroblastoma typically presents with a rapidly enlarging abdominal mass. although the tumor has often spread to distant parts of the body at the time of diagnosis, this cancer is unusual in that many cases are highly curable when the spread is limited to the liver, skin, and/or bone marrow (stage ivs). related, but less aggressive tumors composed of more mature neural cells include "ganglioneuroblastoma" and "ganglioneuroma". neuroblastic tumors often produce elevated levels of catecholamine hormone metabolites, such as vanillylmandelic acid (vma) and homovanillic acid, and may produce severe watery diarrhea through production of vasoactive intestinal peptide. treatment of neuroblastoma includes surgery and radiation therapy for localized disease, and chemotherapy for metastatic disease.