Hypoalbuminemia Associated with Neuroblastoma: A Single Institution Experience

Hypoalbuminemia is common in the intensive care setting, and preoperative hypoalbuminemia is reported to be associated with an increased risk of post-operative complications in adult cancer patients. However, studies of hypoalbuminemia in childhood cancers are scarce. Objective: We conducted a study to look at the incidence of hypoalbuminemia at diagnosis of neuroblastoma, the most common extra-cranial solid cancer in children. Study design: We performed a retrospective chart review of the neuroblastoma cases diagnosed between 2007 and 2013 at our institution. Results: Among the 30 cases with serum albumin levels available at diagnosis, the albumin level was <3.5 g/dL in 16 cases (53%), <3 g/dL in 10 cases (33%), and <2 g/dL in 4 cases (13%). While hypoalbuminemia was multifactorial, we believe that protein-losing-enteropathy, likely due to tumor-related enteric lymphatic obstruction and lymphangiectasia, was one of the causes. Conclusion: Hypoalbuminemia was a frequent finding in our cohort, and further investigation in a larger study is warranted.