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[Arterial hypertension from secretion of catecholamines in an infant with a ganglioneuroblastoma]
Insights
A 16-month-old infant with an abdominal tumor and hypertension was successfully treated with combined alpha and beta blockers. Surgical removal of the ganglioneuroblastoma resolved the condition, with no recurrence after three years.
Area of Science:
- Pediatric Oncology
- Endocrinology
- Nephrology
Background:
- Systemic hypertension in infants can be a sign of underlying serious conditions.
- Pheochromocytoma and neuroblastoma are rare but critical causes of pediatric hypertension.
- Early diagnosis and appropriate management are crucial for favorable outcomes.
Observation:
- A 16-month-old infant presented with an abdominal tumor and severe systemic hypertension.
- Elevated urinary, plasma, and tumor catecholamine levels indicated a pheochromocytoma.
- Preoperative hypertension was managed effectively with a combination of alpha- and beta-blockers.
Findings:
- Complete surgical excision of the tumor was achieved.
- Histopathological examination confirmed the diagnosis of ganglioneuroblastoma.
- No tumor recurrence was observed during a 3-year post-operative follow-up period.
Implications:
- This case highlights the importance of considering neuroblastoma in infants with abdominal masses and hypertension.
- Combined alpha- and beta-blocker therapy is effective for managing catecholamine-induced hypertension.
- Ganglioneuroblastomas with specific enzymatic profiles can synthesize and release pressor amines, leading to hypertension.
Abstract:
The case of a 16 month old infant presenting with an abdominal tumour and systemic hypertension is reported. The profile of urinary plasma and tumour catecholamine levels corresponded with that of a pheochromocitoma. The combination of alphablockers and betablockers was the only effective treatment of the peaks of preoperative hypetension. The tumour was completely excised and was found to be a ganglioneuroblastoma. No recurrence has been observed after 3 years post-operative follow-up. The incidence and mechanisms of hypertension in neuroblastoma are reviewed. Only these histological forms of ganglioblastoma have the enzymatic set up for the synthesis and release of pressor amines.