{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,15]],"date-time":"2026-05-15T17:16:36Z","timestamp":1778865396033,"version":"3.51.4"},"reference-count":25,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2026,4,7]],"date-time":"2026-04-07T00:00:00Z","timestamp":1775520000000},"content-version":"vor","delay-in-days":1,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"NCT Molecular Precision Oncology Program, DKFZ, and DKTK"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,4,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Metastatic cancers of unknown primary (CUP) pose significant diagnostic and therapeutic challenges. We present the case of a 63-year old male patient with a CUP showing neuroendocrine differentiation, metastasized to the iliac bone, bone marrow, supraclavicular and retroperitoneal lymph nodes. Immunohistochemical and molecular profiling revealed strong pan-neurotrophic tyrosine kinase (Trk) expression without NTRK-gene fusion, corroborating the neural cell origin. Following molecular tumor board (MTB) discussion, genome-wide methylation profiling suggested the diagnosis of a neuroblastoma but results were below diagnostic thresholds. Subsequent imaging and laboratory findings confirmed an INRGSS stage M neuroblastoma, a rare finding in older adults. Despite multimodal therapy, including polychemotherapy and immunotherapy according to pediatric GPOH neuroblastoma guidelines, disease progression necessitated an experimental approach. Comprehensive molecular analysis and MTB discussion revealed several potential treatment targets, leading to subsequent treatment including dinutuximab beta, nivolumab, cabozantinib, I-131-mIBG radionuclide therapy and alpelisib, unfortunately, all followed by disease progression. This case demonstrates the potential of comprehensive molecular analysis including methylation profiling for diagnosis and treatment guidance in rare tumors. Additional research is urgently required to improve outcomes in elderly patients with neuroblastoma.<\/jats:p>","DOI":"10.1093\/oncolo\/oyag132","type":"journal-article","created":{"date-parts":[[2026,4,2]],"date-time":"2026-04-02T11:46:38Z","timestamp":1775130398000},"source":"Crossref","is-referenced-by-count":0,"title":["Comprehensive molecular analyses for diagnosis and treatment guidance in an adult neuroblastoma patient"],"prefix":"10.1093","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0027-7977","authenticated-orcid":false,"given":"Damian T","family":"Rieke","sequence":"first","affiliation":[{"name":"German Cancer Consortium (DKTK), Partner Site Berlin, a Partnership between DKFZ and Charit\u00e9 - Universit\u00e4tsmedizin Berlin , Berlin 10117,","place":["Germany"]},{"name":"Charite Comprehensive Cancer Center, Charit\u00e9-Universit\u00e4tsmedizin Berlin, Corporate Member of Freie Universit\u00e4t Berlin and Humboldt-Universit\u00e4t zu Berlin , Berlin 10117,","place":["Germany"]},{"name":"Department of Hematology, Oncology and Cancer Immunology, Campus Benjamin Franklin, Charit\u00e9-Universit\u00e4tsmedizin Berlin, Corporate Member of Freie Universit\u00e4t Berlin and Humboldt-Universit\u00e4t zu Berlin , Berlin 12203,","place":["Germany"]},{"name":"National Center for Tumor Diseases (NCT), NCT Berlin, a Partnership between DKFZ, Charit\u00e9 Universit\u00e4tsmedizin, BIH and MDC , Berlin 10117,","place":["Germany"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stefan","family":"Schwartz","sequence":"additional","affiliation":[{"name":"German Cancer Consortium (DKTK), Partner Site Berlin, a Partnership between DKFZ and Charit\u00e9 - Universit\u00e4tsmedizin Berlin , Berlin 10117,","place":["Germany"]},{"name":"Department of Hematology, Oncology and Cancer Immunology, Campus Benjamin Franklin, Charit\u00e9-Universit\u00e4tsmedizin Berlin, Corporate Member of Freie Universit\u00e4t Berlin and Humboldt-Universit\u00e4t zu Berlin , Berlin 12203,","place":["Germany"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sebastian","family":"Ochsenreither","sequence":"additional","affiliation":[{"name":"German Cancer Consortium (DKTK), Partner Site Berlin, a Partnership between DKFZ and Charit\u00e9 - Universit\u00e4tsmedizin Berlin , Berlin 10117,","place":["Germany"]},{"name":"Charite Comprehensive Cancer Center, Charit\u00e9-Universit\u00e4tsmedizin Berlin, Corporate Member of Freie Universit\u00e4t Berlin and Humboldt-Universit\u00e4t zu Berlin , Berlin 10117,","place":["Germany"]},{"name":"Department of Hematology, Oncology and Cancer Immunology, Campus Benjamin Franklin, Charit\u00e9-Universit\u00e4tsmedizin Berlin, Corporate Member of Freie Universit\u00e4t Berlin and Humboldt-Universit\u00e4t zu Berlin , Berlin 12203,","place":["Germany"]},{"name":"National Center for Tumor Diseases (NCT), NCT Berlin, a Partnership between DKFZ, Charit\u00e9 Universit\u00e4tsmedizin, BIH and MDC , Berlin 10117,","place":["Germany"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bj\u00f6rn","family":"Chapuy","sequence":"additional","affiliation":[{"name":"German Cancer Consortium (DKTK), Partner Site Berlin, a Partnership between DKFZ and Charit\u00e9 - Universit\u00e4tsmedizin Berlin , Berlin 10117,","place":["Germany"]},{"name":"Department of Hematology, Oncology and Cancer Immunology, Campus Benjamin Franklin, Charit\u00e9-Universit\u00e4tsmedizin Berlin, Corporate Member of Freie Universit\u00e4t Berlin and Humboldt-Universit\u00e4t zu Berlin , Berlin 12203,","place":["Germany"]},{"name":"National Center for Tumor Diseases (NCT), NCT Berlin, a Partnership between DKFZ, Charit\u00e9 Universit\u00e4tsmedizin, BIH and MDC , Berlin 10117,","place":["Germany"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Holger","family":"Amthauer","sequence":"additional","affiliation":[{"name":"National Center for Tumor Diseases (NCT), NCT Berlin, a Partnership between DKFZ, Charit\u00e9 Universit\u00e4tsmedizin, BIH and MDC , Berlin 10117,","place":["Germany"]},{"name":"Department of Nuclear Medicine, Charit\u00e9 - Universit\u00e4tsmedizin Berlin, Corporate Member of Freie Universit\u00e4t Berlin and Humboldt-Universit\u00e4t zu Berlin , Berlin 13353,","place":["Germany"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6115-4893","authenticated-orcid":false,"given":"Hedwig E","family":"Deubzer","sequence":"additional","affiliation":[{"name":"German Cancer Consortium (DKTK), Partner Site Berlin, a Partnership between DKFZ and Charit\u00e9 - Universit\u00e4tsmedizin Berlin , Berlin 10117,","place":["Germany"]},{"name":"National Center for Tumor Diseases (NCT), NCT Berlin, a Partnership between DKFZ, Charit\u00e9 Universit\u00e4tsmedizin, BIH and MDC , Berlin 10117,","place":["Germany"]},{"name":"Department of Pediatric Oncology and Hematology, Campus Virchow Klinikum, Charit\u00e9-Universit\u00e4tsmedizin Berlin, Corporate Member of Freie Universit\u00e4t Berlin and Humboldt-Universit\u00e4t zu Berlin , Berlin 13353,","place":["Germany"]},{"name":"Berlin Institute of Health at Charit\u00e9 \u2013 Universit\u00e4tsmedizin Berlin , Berlin 10117,","place":["Germany"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Annika","family":"Lehmann","sequence":"additional","affiliation":[{"name":"Institute of Pathology, Charit\u00e9-Universit\u00e4tsmedizin Berlin, Corporate Member of Freie Universit\u00e4t Berlin and Humboldt-Universit\u00e4t zu Berlin , Berlin 10117,","place":["Germany"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ulrich","family":"Keilholz","sequence":"additional","affiliation":[{"name":"German Cancer Consortium (DKTK), Partner Site Berlin, a Partnership between DKFZ and Charit\u00e9 - Universit\u00e4tsmedizin Berlin , Berlin 10117,","place":["Germany"]},{"name":"Charite Comprehensive 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, Heidelberg 69120,","place":["Germany"]},{"name":"National Center for Tumor Diseases (NCT), NCT Heidelberg, a Partnership between DKFZ and Heidelberg University Hospital , Heidelberg 69120,","place":["Germany"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Horst","sequence":"additional","affiliation":[{"name":"German Cancer Consortium (DKTK), Partner Site Berlin, a Partnership between DKFZ and Charit\u00e9 - Universit\u00e4tsmedizin Berlin , Berlin 10117,","place":["Germany"]},{"name":"Institute of Pathology, Charit\u00e9-Universit\u00e4tsmedizin Berlin, Corporate Member of Freie Universit\u00e4t Berlin and Humboldt-Universit\u00e4t zu Berlin , Berlin 10117,","place":["Germany"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1945-497X","authenticated-orcid":false,"given":"David","family":"Capper","sequence":"additional","affiliation":[{"name":"German Cancer Consortium (DKTK), Partner Site Berlin, a Partnership between DKFZ and Charit\u00e9 - Universit\u00e4tsmedizin Berlin , Berlin 10117,","place":["Germany"]},{"name":"Department of Neuropathology, Charit\u00e9-Universit\u00e4tsmedizin Berlin, Corporate Member of Freie Universit\u00e4t Berlin and Humboldt-Universit\u00e4t zu Berlin , Berlin 10117,","place":["Germany"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8485-1958","authenticated-orcid":false,"given":"Ulrich","family":"Keller","sequence":"additional","affiliation":[{"name":"German Cancer Consortium (DKTK), Partner Site Berlin, a Partnership between DKFZ and Charit\u00e9 - Universit\u00e4tsmedizin Berlin , Berlin 10117,","place":["Germany"]},{"name":"Department of Hematology, Oncology and Cancer Immunology, Campus Benjamin Franklin, Charit\u00e9-Universit\u00e4tsmedizin Berlin, Corporate Member of Freie Universit\u00e4t Berlin and Humboldt-Universit\u00e4t zu Berlin , Berlin 12203,","place":["Germany"]},{"name":"National 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