Catecholamine-secreting extra-adrenal pelvic ganglioneuroma in a child presenting with diaphoresis: A case report and review of literature

• We report a case of pelvic ganglioneuroma in a child who presented with diaphoresis.
• Prolonged diaphoresis in a child warrants screening for catecholamine overproduction.
• Preoperative adrenergic blockade may be indicated in hormonally active ganglioneuroma.

Diaphoresis is an uncommon presenting symptom in children. We present a 4 year old boy, with a history of increased sweating of 2 years duration. Review of systems was negative for diarrhea, flushing, or abdominal pain. On exam, the child had normal blood pressure and heart rate. An abdominal mass could not be appreciated. Laboratory studies were significant for modestly elevated serum, and urinary dopamine and norepinephrine levels. Computerized tomography scan showed a 31 × 39 × 51 mm pelvic mass. The patient underwent laparoscopic resection of the mass. After resection, catecholamine levels normalized, and sweating stopped. Pathologic evaluation of the surgical specimen revealed a maturing ganglioneuroma (GN). Health-care providers might easily overlook excessive sweating in a child, which can be a presenting symptom of catecholamine-secreting tumors.