Severe hypertension and cardiac failure associated with neuroblastoma: A case report

The authors report on a 3-year-old-girl with neuroblastoma complicated by severe hypertension and cardiac failure. She had cardiomegaly and pleural and pericardial effusions. Echocardiogram showed left ventricular hypertrophy and decrease of the left ventricular ejection fraction to 0.36 (normal >...

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Bibliographic Details
Published in:Journal of pediatric surgery 1996-12, Vol.31 (12), p.1688-1690
Main Authors: Sendo, Dai, Katsuura, Michihiko, Akiba, Kaori, Yokoyama, Shinkichi, Tanabe, Saori, Wakabayashi, Takashi, Sato, Satoshi, Otaki, Shinsuke, Obata, Kazuya, Yamagiwa, Iwao, Hayasaka, Kiyoshi
Format: Article
Language:English
Subjects:
Adrenergic alpha-Antagonists - therapeutic use
Biological and medical sciences
Cardiomegaly - etiology
Catecholamines - metabolism
Child, Preschool
Doxazosin - therapeutic use
Female
Ganglioneuroblastoma - complications
Ganglioneuroblastoma - surgery
Humans
Hypertension - drug therapy
Hypertension - etiology
Kidney Neoplasms - complications
Kidney Neoplasms - surgery
Medical sciences
Neurology
Pericardial Effusion - etiology
Pleural Effusion - etiology
Tumors of the nervous system. Phacomatoses
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Summary:The authors report on a 3-year-old-girl with neuroblastoma complicated by severe hypertension and cardiac failure. She had cardiomegaly and pleural and pericardial effusions. Echocardiogram showed left ventricular hypertrophy and decrease of the left ventricular ejection fraction to 0.36 (normal > .40). Abdominal computed tomographic scan indicated a 7 × 7-cm tumor in the left suprarenal area. There was a marked increase in catecholamines and metabolites in her body fluids. After hypertension was controlled with doxazosin (a long-acting α 1 adrenergic blocker), her cardiac function gradually improved. A tumor was surgically removed and diagnosed as a poorly differentiated ganglioneuroblastoma. Preoperative differentiation between neuroblastoma and pheochromocytoma was not possible on the basis of catechol-amine analysis or imaging studies including computed tomography scan and magnetic resonance imaging. It is important to control hypertension quickly in the patients with catechol-amine-induced cardiomyopathy to facilitate surgical intervention for diagnosis and treatment.
ISSN:0022-3468
1531-5037
DOI:10.1016/S0022-3468(96)90051-2