A variety of malignant neoplasms have been reported to cause protein-losing enteropathy (PLE).1 Neuroblastomas are known to cause chronic diarrhea by poorly understood mechanisms of neurohumoral effects on bowel motility and secretions,2 but this tumor is generally not associated with PLE. We have recently seen an unusual case in which a neuroblastoma caused secondary intestinal lymphangiectasia and PLE.
Report of a Case.—An 8-month-old female infant was admitted to Children's Hospital Medical Center, Boston, with chronic diarrhea, periorbital edema, and abdominal distention. The infant had initially thrived on a cow's milk–based formula, and cereals had been introduced at 2 months of age. Three weeks before admission, she had the sudden onset of diarrhea, with ten watery, nonbloody stools per day that persisted despite formula changes. Five days before admission, she had the onset of progressive periorbital swelling.
The infant was pale and chronically ill appearing with a protuberant