Conservative treatment of massive hemothorax in a girl with neuroblastoma.
We report the case of a 1-year-old girl with stage 4 neuroblastoma who developed massive hemothorax due to tumor invasion before treatment. She presented with tachypnea, worsening anemia, and oxygen desaturation. Hemothorax was diagnosed based on chest radiography, ultrasonography, and diagnostic thoracic puncture results. High neuron-specific enolase, vanillylmandelic acid, and homovanillic acid as well as computed tomography strongly supported a diagnosis of neuroblastoma. Chemotherapy along with intermittent puncture drainage, oxygen, and blood transfusion reduced the accumulated blood, and hemothorax disappeared within 1 week. Thus, it is possible to avoid invasive treatment for massive hemothorax by initiating chemotherapy for chemosensitive solid tumors, including neuroblastoma.
Department of Pediatrics, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima City, Kagoshima, Japan.
Naohiro
N
Shiokawa
Department of Pediatrics, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima City, Kagoshima, Japan. okamoto@m2.kufm.kagoshima-u.ac.jp.
Yasuhiro
Y
Okamoto
Department of Pediatrics, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima City, Kagoshima, Japan.
Yuichi
Y
Kodama
Department of Pediatrics, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima City, Kagoshima, Japan.
Takuro
T
Nishikawa
Department of Pediatrics, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima City, Kagoshima, Japan.
Takayuki
T
Tanabe
Department of Pediatric Surgery, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima City, Kagoshima, Japan.
Motoi
M
Mukai
Department of Pathology, Kagoshima University Medical and Dental Hospital, Kagoshima City, Kagoshima, Japan.|Department of Pathology, National Center of Child Health and Development, Setagaya, Tokyo, Japan.
Takako
T
Yoshioka
Department of Pediatrics, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima City, Kagoshima, Japan.
Yoshifumi
Y
Kawano
D001859:Bone Neoplasms / Q000150:complications* / Q000175:diagnosis / Q000628:therapy; D000072700:Conservative Treatment / Q000379:methods*; D005260:Female; D006491:Hemothorax / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D006801:Humans; D007223:Infant; D009361:Neoplasm Invasiveness; D009447:Neuroblastoma / Q000150:complications* / Q000175:diagnosis / Q000628:therapy; D013902:Radiography, Thoracic; D014057:Tomography, X-Ray Computed
chemotherapy; hemothorax; neoplasm; neuroblastoma; tumor