Neuroblastic Tumor Causing Toe-Walking Without Mechanical Compression of the Spinal Cord or Nerve Roots

We describe two children with peripheral neuroblastic tumors (PNTs; ganglioneuroma and ganglioneuroblastoma) remote from neural structures.They presented with toe-walking, ankle contractures, and pes cavus.In both cases, symptoms resolved after resection of the PNT and without orthopedic intervention.These cases highlight that PNTs can cause toe-walking, even without compression of neural structures, and should be considered in the differential diagnosis of toe-walking in children. CasesCase one is a three-year-old male with a history of chronic diarrhea, who developed toe-walking at the age of 2 years.On examination, he toe-walked and had bilateral pes cavus, restricted ankle dorsiflexion, and lower limb hyporeflexia.