[Neuroblastoma, factor of early decompensation of tetralogy of Fallot].
The authors report the case of a tetralogy of Fallot associated with a neuroblastoma secreting large quantities of noradrenaline. Anoxic decompensation of the tetralogy of Fallot occurred early at the age of 4 months with cyanotic crises associated with an impression of abdominal pain. A systemic-pulmonary anastomosis was performed and the cyanosis regressed but the crises persisted and investigations showed the presence of a neuroblastoma. The tumour was treated by surgery and chemotherapy and has not recurred after 2 years' follow-up. Complete repair of the tetralogy of Fallot was performed secondarily at the age of 2. In this case, the high concentration of circulating catecholamines was probably a factor of early decompensation of the tetralogy of Fallot by infundibular spasm. A review of the literature revealed 26 cases of cardiac disease with a peripheral neurogenic tumour. Two pathogenic mechanisms are suggested: an embryological abnormality of cardiac cell migration from the neural crest and chronic stimulation of neuroblastic cells by chronic hypoxia.
Voisin
M
M
Unité de cardio-pneumologie pédiatrique, hôpital Saint-Charles, Montpellier.
Guillaumont
S
S
Margueritte
G
G
Bernard
F
F
Galifer
R B
RB
Barneon
G
G
Couture
A
A
D006801:Humans; D007223:Infant; D008297:Male; D009432:Neural Crest; D009447:Neuroblastoma / Q000150:complications / Q000151:congenital* / Q000628:therapy; D009638:Norepinephrine / Q000097:blood; D013771:Tetralogy of Fallot / Q000150:complications* / Q000601:surgery; D013899:Thoracic Neoplasms / Q000150:complications / Q000151:congenital* / Q000628:therapy
D009638:Norepinephrine
Neuroblastome facteur de décompensation précoce d'une tétralogie de Fallot.