Abstract B054: Chylous malignant pleural effusion in pediatric neuroblastoma: A rare and fatal presentation

Abstract Neuroblastoma (NB) is a rare pediatric embryonal malignancy, Accounting for approximately 7% of all pediatric cancers, with a five-year survival rate less than 50% in high-risk NB patients. This case represents the fourth documented occurrence of chylous malignant pleural effusion (MPE) complicated with respiratory distress as a presentation of neuroblastoma in a 10-month-old female diagnosed with stage M metastatic disease. She was initially treated with three chemotherapy cycles according to the COG-A3961 protocol, yielding a suboptimal response and necessitating a more aggressive approach. Therefore, she received four cycles after switching to the ICE-5 protocol as a second line treatment, supplemented with medium-chain triglyceride (MCT) oil along with octreotide infusion following a week of fasting. Despite Regular follow-ups and imaging demonstrating significant disease regression, with an excellent treatment response estimated at 80–90%, The patient passed away due to causes unrelated to disease progression before completing her treatment. MPE could be a marker of advanced disease and might require an aggressive treatment regimen. Citation Format: Sara Omar Abu Aleenein, Saif Aldeen Rawabdeh, Faten Awwad, Lama Bani Salameh, Bassem Bataineh, Suleimman Al-Sweedan. Chylous malignant pleural effusion in pediatric neuroblastoma: A rare and fatal presentation [abstract]. In: Proceedings of the AACR Special Conference in Cancer Research: Discovery and Innovation in Pediatric Cancer— From Biology to Breakthrough Therapies; 2025 Sep 25-28; Boston, MA. Philadelphia (PA): AACR; Cancer Res 2025;85(18_Suppl_2):Abstract nr B054.