Refractory dilated cardiomyopathy associated with metastatic neuroblastoma.
A 2-year-old African American male presented with heart failure and an abdominal mass. Computerized tomography (CT) scan revealed a 7 cm adrenal lesion, confirmed as poorly differentiated neuroblastoma (NB). CT and meta-iodobenzoguanidine (MIBG) scans identified multiple metastases, but cardiac MIBG imaging was absent. Cardiac ejection fraction (EF) was 8% with 7% shortening fraction. The patient underwent six cycles of chemotherapy and investigational immunotherapy. Cardiac function improved to 26% EF. However, the tumor proved unresponsive to treatment. The patient died from stage IV congestive heart failure (CHF) and progressive NB. Autopsy confirmed dilated cardiomyopathy with endocardial fibroelastosis.
Carlson
Peter
P
Baylor College of Medicine, Houston, Texas, USA.
Jefferies
John L
JL
Kearney
Debra
D
Russell
Heidi
H
D002311:Cardiomyopathy, Dilated / Q000209:etiology*; D002675:Child, Preschool; D004695:Endocardial Fibroelastosis / Q000209:etiology; D006801:Humans; D008297:Male; D009447:Neuroblastoma / Q000150:complications* / Q000556:secondary