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 ventricu lar hypertrophy and decrease of the left ventricular ejection fraction to 0.36 (normal > .40). Abdominal computed tomographic scan indicated a 7 x 7-cm tumor in the left suprarenal area. There was a marked incr ease in catecholamines and metabolites in her body fluids. After hyper tension was controlled with doxazosin (a long-acting alpha 1 adrenergi c blocker), her cardiac function gradually improved, A tumor was surgi cally removed and diagnosed as a poorly differentiated ganglioneurobla stoma. Preoperative differentiation between neuroblastoma and pheochro mocytoma was slot possible on the basis of catecholamine analysis or i maging studies including computed tomography scan and magnetic resonan ce imaging, It is important to control hypertension quickly in the pat ients with catecholamine induced cardiomyopathy to facilitate surgical intervention for diagnosis and treatment. Copyright (C) 1996 by W.B. Saunders Company