Development of hypertension in neuroblastoma during therapy: a case report.
A case of stage 4 neuroblastoma that developed excessive hypertension on day 120 of chemotherapy is presented. The tumor initially had responded well to chemotherapy; however, while the tumor mass decreased, plasma and urine catecholamines and the blood pressure increased. The plasma concentrations of noradrenaline, adrenaline, and dopamine increased to 26.4, 1.8, and 36.2 micrograms/l, respectively. The profile of catecholamine metabolites changed: on day 150 of therapy, noradrenaline, adrenaline, and dopamine levels were increased, whereas HVA and VMA levels were decreased when compared to day 1 of therapy. The only residual neuroblastoma tissue visible on MIBG scintigraphy on day 150 of treatment was a metastasis in the left tibia which was irradiated with 24 Gy. The adrenaline concentration in the left femoral vein was twice as high compared to the right femoral vein. A treatment, possibly radiation-associated tumor cell alteration resulting in a different catecholamine production, is discussed.
Department of Pediatric Oncology, University Hospital of Münster, Germany.
J E
JE
Wolff
H J
HJ
Bauch
A
A
Roessner
J
J
Boos
V
V
Gressner-Brocks
J
J
Ritter
H
H
Jürgens
D000008:Abdominal Neoplasms / Q000097:blood / Q000188:drug therapy* / Q000473:pathology; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects*; D002395:Catecholamines / Q000097:blood*; D002675:Child, Preschool; D006801:Humans; D006973:Hypertension / Q000097:blood / Q000139:chemically induced*; D008297:Male; D009447:Neuroblastoma / Q000097:blood / Q000188:drug therapy* / Q000556:secondary
D002395:Catecholamines