Diarrea intrattabile e neuroblastoma

A previously healthy three-year-old girl presented with persistent diarrhoea, progressive abdominal distension and weight loss. After negative infectious and anatomical workup, abdominal imaging (ultrasound, MRI and CT) revealed a retroperitoneal mass consistent with neuroblastoma (NB), confirmed by image-guided biopsy. Urinary catecholamines were markedly elevated. Following initial chemotherapy, worsening symptoms and refractory diarrhoea prompted surgical resection of the tumour. The diarrhoea was attributed to vasoactive intestinal peptide (VIP) secretion, a rare presentation in NB. Postoperative recovery was uneventful, with clinical and radiologic remission at six months. This case highlights the need to consider NB in chronic paediatric diarrhoea and supports surgery as the treatment of choice in VIP-secreting tumours.