アブストラクト
Japanese
| Title | カテコラミン過剰症状を呈した新生児期発症神経芽腫の1例 |
|---|---|
| Subtitle | 原著 |
| Authors | 大久保光将, 児玉洋平, 中野玲二 |
| Authors (kana) | |
| Organization | 静岡県立こども病院 新生児科 |
| Journal | 日本新生児成育医学会雑誌 |
| Volume | 35 |
| Number | 2 |
| Page | 274-279 |
| Year/Month | 2023 / 6 |
| Article | 原著 |
| Publisher | 日本新生児成育医学会 |
| Abstract | 「要旨」神経芽腫はカテコラミン産生腫瘍であるが, 実際にカテコラミン過剰症状を呈することは稀である. 新生児期よりカテコラミン過剰症状 (高血圧, 頻脈, 発汗過多, 体重増加不良) を呈し, 画像検査所見が非典型的であり褐色細胞腫との鑑別を要した症例を経験した. 症例は日齢8の男児で血性の嘔吐を主訴に入院した. 超音波検査で右腎上極に腫瘤を認め, 神経芽腫を疑って当院へ転院した. 血中カテコラミン異常高値 (アドレナリン135pg/mL, ノルアドレナリン78,156pg/mL, ドーパミン2,924pg/mL) が判明した. 腫瘤は充実性で石灰化を認めず, MIBGシンチグラムは陰性であったが, 褐色細胞腫を否定できなかった. 術前管理としてカテコラミン過剰症状の抑制と循環血液量の是正を行い, 日齢42に腫瘍を摘出し, 病理検査で神経芽腫と診断した. 周術期の合併症はなかった. カテコラミン過剰症状は消失した. 合併症なく摘出するためには術前管理が重要である. |
| Practice | 臨床医学：内科系 |
| Keywords | neuroblastoma, catecholamine excess symptoms, perioperative management |
English
| Title | A Neonatal Case of Neuroblastoma with Catecholamine Excess Symptoms |
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| Subtitle | |
| Authors | Mitsuyuki OKUBO, Yohei KODAMA, Reiji NAKANO |
| Authors (kana) | |
| Organization | Department of Neonatology, Shizuoka Children's Hospital |
| Journal | Journal of Japan Society for Neonatal Health and Development |
| Volume | 35 |
| Number | 2 |
| Page | 274-279 |
| Year/Month | 2023 / 6 |
| Article | Original article |
| Publisher | Japan Society for Neonatal Health and Development |
| Abstract | While catecholamine-producing tumors of childhood include neuroblastomas and pheochromocytomas, only a few neonates with excess symptoms have been reported. We report a case of neonatal neuroblastoma with catecholamine excess symptoms. An 8-day-old boy was admitted to our hospital because of blood in vomit. A mass in upper right kidney was found on ultrasound. He had catecholamine excess symptoms. Plasma catecholamine levels were high (adrenaline 135 pg/mL, noradrenaline 78,156 pg/mL, dopamine 2,924 pg/mL). Computed tomography scan showed no calcification, 123I-MIBG scintigraphy showed no accumulation of the tracer in the mass. Distinction between neuroblastoma and pheochromocytoma could not be made based on the findings of these image examinations. At day 43, laparotomy tumor resection was performed without any complications, followed by preoperative management to reduce catecholamine excess symptoms. Intraoperative tachycardia and hypertension were managed with adjustment of anesthesia. Pathological diagnosis was neuroblastoma. Since the tumor resection, catecholamine excess symptoms, including tachycardia and hypertension, have gradually disappeared and plasma catecholamine levels have decreased. The perioperative management is important for resecting a tumor with catecholamine excess symptoms. |
| Practice | Clinical internal medicine |
| Keywords | neuroblastoma, catecholamine excess symptoms, perioperative management |
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参考文献
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