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Severe hypertension in a child with ganglioneuroblastoma
Author(s) -
Kedar Amos,
Freeman Arnold I.,
Glassman Mark,
Voorhess Mary L.,
Fisher John,
Allen James,
Jenis Edwin
Publication year - 1981
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/1097-0142(19810415)47:8<2077::aid-cncr2820470828>3.0.co;2-o
Subject(s) - ganglioneuroblastoma , medicine , pediatrics , neuroblastoma , ganglioneuroma , genetics , biology , cell culture
A 26‐month‐old boy with Stage III abdominal ganglioneuroblastoma had tachycardia and hypertension. The hypertension increased following the institution of chemotherapy and necessitated the use of both alpha and beta adrenergic blocking agents to control the effects of the marked catecholamine production. After excision of the residual tumor, the blood pressure and urinary catecholamine excretion returned to normal. Histologic examination of this tissue under light microscopy revealed some sections of ganglioneuroblastoma as well as large areas of ganglioneuroma. Examination by electron microscopy demonstrated a moderate number of dense core neurosecretory‐type granules in the cell bodies of the ganglion‐like cells and an abundance of the same type of granules in the bundles of the interwoven cytoplasmic neural processes. To date, 32 months after diagnosis and 20 months off chemotherapy, the patient remains free of tumor and is in excellent general health. We postulate that the large number of secretory granules in this tumor permitted storage and release of markedly increased quantities of norepinephrine and resulted in a clinical profile similar to that associated with pheochromocytoma.