en Pediatric Hematology & Oncology Pediatric Hematology & Oncology گزارش مورد Case report <p style="text-align: justify;"><span style="font-size:14px;"><span style="line-height:2;"><span style="font-family:Times New Roman;"><strong>Background: </strong>Neuroblastoma is the most common extracranial solid tumor in children, typically arising from the adrenal glands or abdominal sympathetic chain. Thoracic involvement, particularly in the posterior mediastinum, is rare and may present with nonspecific respiratory symptoms. When adjacent cardiac structures are compressed, clinical severity increases, posing diagnostic and therapeutic challenges.<br> <strong>Case Presentation:</strong> A one-year-old girl presented with persistent wheezing and recurrent pneumonia unresponsive to antibiotics. Initial imaging suggested pulmonary sequestration, but further evaluation&mdash;including echocardiography and angiography&mdash;revealed a posterior mediastinal mass compressing the left atrium and ventricle. Biopsy confirmed neuroblastoma. No metastasis was found on staging. Classified as intermediate-risk, she was treated per the Children&rsquo;s Oncology Group (COG) A3961 protocol with chemotherapy. Treatment was well-tolerated, symptoms improved, and follow-up imaging showed significant tumor reduction without complications or recurrence.<br> <strong>Conclusion: </strong>Posterior mediastinal neuroblastoma may mimic common respiratory illnesses, delaying diagnosis. Cardiac compression can worsen symptoms and increase risks. Early recognition, accurate diagnosis, and multidisciplinary care are essential for favorable outcomes, as demonstrated by this case with no treatment complications or tumor recurrence on follow-up.</span></span></span></p> Neuroblastoma, Chemotherapy, Pediatrics, Cardiac Compression, Thoracic Tumors 13 23 http://ijbc.ir/browse.php?a_code=A-10-1602-1&slc_lang=en&sid=1 Mohsen Rahmanian 100319475328460012650 100319475328460012650 No School of Medicine, North Khorasan University of Medical Sciences, Bojnord, Iran. Sarah Khosropanah 100319475328460012651 100319475328460012651 Yes School of Medicine, North Khorasan University of Medical Sciences, Bojnord, Iran Amir Muhammad Khuban Azghadi 100319475328460012652 100319475328460012652 No School of Medicine, North Khorasan University of Medical Sciences, Bojnord, Iran Hamid Farhangi FarhangiH@mums.ac.ir 100319475328460012653 100319475328460012653 No Department of Pediatrics Hematology and Oncology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran