Infantile Ganglioneuroblastoma Causing Growth Failure and Hypertensive Cardiomyopathy From Excessive Catecholamine Production

Unlike pheochromocytomas, neuroblastomas-which are the most common pediatric extracranial solid tumors-are rarely associated with cardiomyopathy and heart failure due to hypertension. We report the case of a 3-year-old girl with growth failure who had hypertensive cardiomyopathy caused by excessive epinephrine and norepinephrine production from a ganglioneuroblastoma. Circulation improved with alpha-blockers and other medications, which enabled partial tumor resection. Histopathologic analysis confirmed ganglioneuroblastoma. Four courses of James' therapy did not lead to tumor shrinkage; subtotal resection was required, which reduced catecholamine levels. This case underscores the importance of multidisciplinary treatment for hypertensive cardiomyopathy due to excess neuroblastoma-related catecholamines.