Abstract
We report the case of a 40-day-old boy, who presented to hospital with tachypnea and sudden pallor. A pleural effusion in the left chest was observed on the chest X-ray. He was ventilated and thoracic drainage was performed because of degradation of his respiratory status. Computed Tomography as well as Magnetic Resonance Imaging supported strongly the diagnosis of mediastinal neuroblastoma. The extension assessment was negative. We opted for a conservative treatment by chemotherapy, and the courses proceeded favourably. After neoadjuvant chemotherapy, the residual mass was resected completely through a left thoracotomy. Histopathological examination established the final diagnosis of ganglioneuroblastoma. Thus, it is possible to avoid invasive treatment for massive hemothorax caused by neuroblastoma by initiating chemotherapy.
Highlights
Neuroblastoma is the most common solid tumor in newborn and the most common extracranial solid tumor in infancy
The authors report this clinical case to highlight the efficacy of conservative treatment in mediastinal neuroblastoma complicated by hemothorax
As part of the etiological assessment of the hemothorax, a thoracic computerized tomography (CT) was performed. It revealed a voluminous tissue mass in the left posterior infra-mediastinal space extended to the subdiaphragmatic space, suggesting first and foremost a thoracic neuroblastoma with intra-channel extension and the presence of multiple imaging-defined risk factors (IDRF) (Figure 3)
Summary
Neuroblastoma is the most common solid tumor in newborn and the most common extracranial solid tumor in infancy. Its management depends on the location of tumor, the extent of metastatic disease and the respiratory distress at diagnosis The authors report this clinical case to highlight the efficacy of conservative treatment in mediastinal neuroblastoma complicated by hemothorax. As part of the etiological assessment of the hemothorax, a thoracic computerized tomography (CT) was performed It revealed a voluminous tissue mass in the left posterior infra-mediastinal space extended to the subdiaphragmatic space, suggesting first and foremost a thoracic neuroblastoma with intra-channel extension and the presence of multiple imaging-defined risk factors (IDRF) (Figure 3). No microorganism was seen on gram exam and there was no growth on culture of the pleural liquid He was gradually weaned to room air and Oxygen therapy was stopped one week after chemotherapy infusion and chest radiography improved. The infant is asymptomatic, and his Chest X-ray is normal
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