A catecholamine-secreting neuroblastoma leading to hydrops fetalis.
A case of fetal neuroblastoma of the right adrenal gland, with rapid development of hydrops fetalis due to catecholamine-induced cardiomyopathy, is reported. A fetus with a right suprarenal mass detected during ultrasonography at 32 weeks gestation progressively developed into hydrops fetalis by 35.2 weeks gestation. An emergent cesarean section was performed. At birth, the female neonate was hypertensive, with markedly elevated catecholamine levels; echocardiography showed poor contractility. Morphine, human atrial natriuretic peptide, milrinone, nitroprusside and dobutamine were initiated and her blood pressure was maintained within the normal range and her cardiac contractility improved 2 weeks after birth. Neuroblastoma cells were detected in the placenta, resulting in the right adrenal mass being diagnosed as a neuroblastoma. She was well, and the mass diminished in size within 4 months, without surgery. A fetus with suspected neuroblastoma, indicated by a suprarenal mass, should be managed with appropriate consideration of hydrops.
Center for Maternal-Fetal and Neonatal Medicine, National Center for Child Health and Development, Tokyo, Japan.
T
T
Inoue
Center for Maternal-Fetal and Neonatal Medicine, National Center for Child Health and Development, Tokyo, Japan.
Y
Y
Ito
Center for Maternal-Fetal and Neonatal Medicine, National Center for Child Health and Development, Tokyo, Japan.
T
T
Nakamura
Department of Pathology, National Center for Child Health and Development, Tokyo, Japan.
K
K
Matsuoka
Center for Maternal-Fetal and Neonatal Medicine, National Center for Child Health and Development, Tokyo, Japan.
H
H
Sago
D000310:Adrenal Gland Neoplasms / Q000150:complications* / Q000378:metabolism*; D000328:Adult; D009202:Cardiomyopathies / Q000209:etiology; D002395:Catecholamines / Q000378:metabolism*; D002585:Cesarean Section; D005260:Female; D005315:Fetal Diseases / Q000503:physiopathology*; D006801:Humans; D015160:Hydrops Fetalis / Q000209:etiology*; D007231:Infant, Newborn; D009447:Neuroblastoma / Q000150:complications* / Q000378:metabolism*; D011247:Pregnancy
D002395:Catecholamines