Posterior mediastinal neuroblastoma masked as flaccid paraparesis in a 3 year child

Neuroblastoma is an embryonic tumor of the sympathetic nervous system originating from neural crest cell remnants, which may be found in the adrenal glands or sympathetic chain. We report a case of a three-year-old girl who presented with flaccid paraparesis, and acute respiratory distress that requ...

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Bibliographic Details
Published in:Neurosciences (Riyadh, Saudi Arabia) Saudi Arabia), 2019-10, Vol.24 (4), p.320-323
Main Authors: Yahya, Farah S, Al-Shami, Hieder A
Format: Article
Language:English
Subjects:
Cancer
Case Report
Chemotherapy
Child, Preschool
Diagnosis
Diagnosis, Differential
Female
Humans
Magnetic Resonance Imaging
Mediastinal Neoplasms - diagnostic imaging
Mediastinal Neoplasms - pathology
Neuroblastoma
Neuroblastoma - diagnostic imaging
Neuroblastoma - pathology
Paraparesis - diagnostic imaging
Paraparesis - pathology
Radiography
Vincristine
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Summary:Neuroblastoma is an embryonic tumor of the sympathetic nervous system originating from neural crest cell remnants, which may be found in the adrenal glands or sympathetic chain. We report a case of a three-year-old girl who presented with flaccid paraparesis, and acute respiratory distress that required mechanical ventilation after a multiple-day history of gradual-onset dyspnea and right upper-lung opacity that was initially misdiagnosed as pneumonia. Chest and spinal magnetic resonance imaging (MRI) revealed a tumor in the posterior mediastinum with intra-spinal canal extension. The patient underwent thoracotomy and surgical en bloc resection with spinal canal decompression. Histopathology revealed neuroblastoma. The postoperative period was uneventful. The patient was administered a course of chemotherapy but died due to advanced stage tumor, severe pancytopenia, and septicemia with renal failure. The aim of this report is to consider posterior mediastinal neuroblastoma in the differential diagnosis of dyspnea and acute lower limb weakness in young children.
ISSN:1319-6138
1319-6138
DOI:10.17712/nsj.2019.4.20190036