Abstract Neonatal chylothorax is a common cause of neonatal congenital pleural effusion and is often caused by the accumulation of chylous fluid in the thoracic cavity due to the rupture of the thoracic duct and its branched lymphatic vessels for a variety of reasons. Neonatal chylothorax caused by malignant tumors is extremely rare, and this is the first case of neonatal mediastinal neuroblastoma with chylothorax in China. The boy was found to have pleural effusion in the left thoracic cavity in the uterus, and experienced apnea at birth, as well as dyspnea and cyanosis as the main manifestations after birth. He was diagnosed with left chylothorax based on conventional biochemical analysis of pleural effusion. After the treatment including persistent chest drainage and symptomatic and supportive treatment, the drainage of the left thoracic cavity reached a volume of 90-180 mL per day. Neonatal refractory chylothorax was considered. Chest radiograph on day 13 after birth showed lesions in the upper left lung field, and contrast-enhanced plain CT scan of the chest suggested the possibility of posterior mediastinal neuroblastoma. The autopsy confirmed giant posterior mediastinal neuroblastoma (poorly differentiated), which involved the C7-T6 spinal canal and the nearby erector spinae, with a small amount of tumor tissue in the liver and both adrenal glands. Mediastinal tumor is considered the underlying cause of chylothorax in this case.
Wu C, Wang Y, Pan Z, et al. Analysis of the etiology and treatment of chylothorax in 119 pediatric patients in a single clinical center[J]. J Pediatr Surg, 2019, 54(7):1293-1297.
[10]
Patel R, Griselli M, Barrett AM. Congenital extensive central venous thrombosis with chylous ascites and chylothoraces[J]. J Pediatr Surg, 2013, 48(2):e5-e8.
[11]
王斯瑶. 30例新生儿乳糜胸(腹)临床分析[D]. 沈阳:中国医科大学, 2019.
[12]
Kazemian M, Fallahi M, Rouzrokh M, et al. Neonatal neuroblastoma presented with respiratory distress, a case report[J]. Respir Med Case Rep, 2019, 28:100874.
LI Qian-Qian, DONG Xiao-Yue, QIAO Yu, YIN Yu-Jie, GAO Yan, ZHOU Jin-Jun, YANG Li, ZHU Rong-Ping, WANG Fu-Dong, WAN Jun, XU Yan, PAN Zhao-Jun, WANG Wei-Yuan, YAN Jun-Mei, HAN Shu-Ping, LU Hong-Yan, HU Yu-Hua, LI Shuang-Shuang, WANG Jin-Xiu, WU Ming-Fu, WANG Jun, DENG Xiao-Yi, YU Zhang-Bin. An investigation of severe neonatal hyperbilirubinemia in 13 hospitals of Jiangsu Province, China[J]. CJCP, 2020, 22(7): 690-695.
