Dilated cardiomyopathy in a child with abdominal neuroblastoma and normal serum catecholamine levels: anaesthetic management and review of literature

Abstract

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.

Bilateral Nephroblastoma with Dilated Cardiomyopathy as an Indication for Off-Protocol Treatment: A Case Report

“…The pathophysiology of renovascular hypertension is due to an initial reduction in renal perfusion that occurs as a result of stenosis of the main renal artery or one of its branches. Heart failure is explained as secondary to the secretion of renin and angiotensin II, a vasoactive agent other than renin or catecholamines [ 10 , 11 , 12 ]. Hence, Trebo et al recommend routine echocardiography for patients with a suspected Wilms tumor [ 6 ].…”

“…Similarly, Ganigara et al presented a case report of neuroblastoma accompanied by dilated cardiomyopathy without elevated levels of catecholamines. The reason for hypertension was probably the compression of the renal artery by the huge tumor, which resulted in high levels of serum renin and angiotensin [ 12 ].…”

Serum brain natriuretic peptide levels may be a useful marker for early diagnosis of cardiomyopathy secondary to neuroblastoma: A case report

“…1 Although rare, there have been several reports of secondary cardiomyopathic complications due to excess catecholamines that may lead to severe heart failure symptoms. [2][3][4][5][6][7][8] A few patients present with hypertrophic cardiomyopathy, of which dilated cardiomyopathy (DCM) is commonly observed. 9,10 According to previous reports, cardiomyopathy improves after neuroblastoma treatment.…”

“…It constitutes approximately 7% of all malignant tumors experienced during childhood 1 . Although rare, there have been several reports of secondary cardiomyopathic complications due to excess catecholamines that may lead to severe heart failure symptoms 2–8 …”