Pediatrik servikal intramedüller anaplastik astrositom olgusu ve kısa derleme

İntramedüller spinal kord tümörleri çocukluk çağında nadirdir. Genellikle sinsi bir seyri vardır, ve ağrı en sık rastlanan semptomdur. Burada akut olarak, artan güçsüzlük, solunum yetmezliği ve bilinç kaybı ile başvuran 7 yaşında kız çocuğunda gördüğümüz nadir bir spinal intramedüller astrositom vakasını sunmak istedik. Endotrakeal entübasyon sonrasında bilinci açılan, fakat alt ve üst ekstremitelerde flask paralizi izlenen hastanın detaylı anamnezinde 6 haftadır geçmeyen sol kol ağrısı olduğu öğrenildi. Çekilen spinal manyetik görüntülemesinde (MRG) izlenen yaygın bulboservikal lezyon öncellikle demiyelizan bir hastalık lehine yorumlanmakla beraber, tekrarında servikal intramedüller tümör lehine değerlendirildi. Vakamızda kötüleşen MRG bulguları bizi dekompresyona yöneltti ve tümör totale yakın olarak çıkartıldı. Patolojik inceleme sonucunda anaplastik astrositom saptandı.

A case of pediatric cervical intramedullary anaplastic astrocytoma and a short review of literature

Intramedullary spinal cord tumors are rare in childhood. Their presentation is often insidious, and pain is the most common presenting symptom. We present a sevenyear- old girl who had acutely worsening weakness, respiratory insufficiency and loss of consciousness on admission. She regained consciousness after endotracheal intubation, but remained with flask paralysis of four extremities. Detailed history revealed that she had an unrelenting left arm pain followed by weakness for six weeks. The magnetic resonance imaging (MRI) of her spine pointed out an extensive bulbocervical lesion, which was thought to be a demyelinating process initially, but repeat MRI pointed towards the diagnosis of cervical intramedullary tumor. In our case, worsening of MRI findings lead us to a decompressive surgical strategy and near-total removal of the lesion. The pathology results revealed an anaplastic astrocytoma.

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