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.