Abstract
IntroductionMedulloblastoma is one of the most common pediatric brain malignancies. The usual presenting clinical features are related to posterior fossa syndrome or/and hydrocephalus. Cauda equina syndrome is a very rare presentation for this disease.Case presentationWe describe the case of a three-year-old boy with cauda equina syndrome as the initial presenting clinical feature for medulloblastoma. He was initially diagnosed as having a spinal tumor by magnetic resonance imaging scan. Subsequently, a cranial magnetic resonance imaging scan revealed a posterior fossa tumor with features of dissemination. He had substantial improvement after treatment. This case report is complemented by a literature review related to this unusual presentation.ConclusionsMedulloblastoma primarily presenting with cauda equina syndrome is very rare. However, spinal drop metastasis should be considered in the pediatric age group to avoid suboptimal management.
Highlights
Medulloblastoma is one of the most common pediatric brain malignancies
Medulloblastoma primarily presenting with cauda equina syndrome is very rare
Spinal drop metastasis should be considered in the pediatric age group to avoid suboptimal management
Summary
Medulloblastoma is the second most common posterior fossa tumor in children. It accounts for 40% of posterior fossa tumors in the pediatric age group [1]. We report the case of a child with medulloblastoma who presented with progressive paraparesis caused by cauda equina drop metastasis without symptoms related to the primary intracranial tumor. Upon reviewing his spinal MRI, drop metastasis was suspected. A cranio-spinal MRI scan was performed, which showed a posterior fossa tumor associated with radiographic features of intracranial and spinal metastasis, (Figures 1A, B and 2A). Since our patient was young and the clinical course was atypical, immunostaining for integrase interactor 1 (INI-1) protein (BAF47; BD Biosciences, clone 25, 1:200) was performed and the neoplastic cells were uniformly immunoreactive to it (Figure 3C) This practically excludes atypical teratoid/rhabdoid tumor as a diagnostic possibility. At the time of writing this report, he has retained good neurological function
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
