Giant, dopamine secreting thoracoabdominal neuroblastoma in a 2-year-old: rapid preoperative blockade with labetalol.
Neuroblastomas secreting large amounts of catecholamines may require preoperative antihypertensive treatment to avoid intraoperative hypertensive crises as do pheochromocytomas. This is typically achieved with alpha-adrenergic followed if necessary by beta-adrenergic receptor blockade. Because of its predominant beta-blockade, labetalol as a combined alpha-adrenergic and beta-adrenergic receptor antagonist is relatively contraindicated as sole and first agent in pheochromocytomas releasing epinephrine and norepinephrine. We report successful monotherapy with labetalol over 24 hours in a 2-year-old child with a giant thoracoabdominal neuroblastoma and predominant dopamine secretion.
Pappas
Lisbeth
L
Departments of Anesthesiology, Children's Hospital Boston, Harvard Medical School, Boston, MA, USA.
Shamberger
Robert C
RC
Seefelder
Christian
C
D000008:Abdominal Neoplasms / Q000378:metabolism* / Q000503:physiopathology / Q000601:surgery; D000317:Adrenergic alpha-Antagonists / Q000627:therapeutic use*; D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use*; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D001794:Blood Pressure / Q000187:drug effects; D004298:Dopamine / Q000378:metabolism*; D005260:Female; D006801:Humans; D007223:Infant; D007741:Labetalol / Q000627:therapeutic use*; D009447:Neuroblastoma / Q000378:metabolism* / Q000503:physiopathology / Q000601:surgery; D013899:Thoracic Neoplasms / Q000378:metabolism* / Q000503:physiopathology / Q000601:surgery
D000317:Adrenergic alpha-Antagonists; D000319:Adrenergic beta-Antagonists; D000959:Antihypertensive Agents; D007741:Labetalol; D004298:Dopamine