Neuroblastoma is the most common extracranial solid tumour of childhood. Dilated cardiomyopathy as an initial presentation of neuroblastoma is rare. We report the case of a three-year-old child with giant abdominal neuroblastoma encasing the abdominal aorta who presented with dilated cardiomyopathy in heart failure without hypertension or elevated serum catecholamine levels. The probable pathophysiological mechanism for such an occurrence and review of similar cases along with perioperative management is presented.
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