A case of neuroblastoma in an adult with extensive metastatic lesions is presented. The initial symptoms and findings suggested idiopathic thrombocytopenic purpura. The blood picture and changes in the clinical picture later led to a diagnosis of acute leukemia. Autopsy disclosed the correct diagnosis, which would have been possible antemortem had the implication of pseudorosette arrangement of immature cells in the bone marrow and the possible occurrence of neuroblastoma in an adult been fully appreciated.

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