Giant, Dopamine Secreting Thoracoabdominal Neuroblastoma in a 2-year-old: Rapid Preoperative Blockade With Labetalol

Neuroblastomas secreting large amounts of catecholamines may require preoperative antihypertensive treatment to avoid intraoperative hypertensive crises as do pheochromocytomas. This is typically achieved with alpha-adrenergic followed if necessary by beta-adrenergic receptor blockade. Because of its predominant beta-blockade, labetalol as a combined alpha-adrenergic and beta-adrenergic receptor antagonist is relatively contraindicated as sole and first agent in pheochromocytomas releasing epinephrine and norepinephrine. We report successful monotherapy with labetalol over 24 hours in a 2-year-old child with a giant thoracoabdominal neuroblastoma and predominant dopamine secretion.