Additional pediatric resources: GeneralPediatrics.com | PediatricEducation.org | SearchingPediatrics.com
Correlapaedia - a Correlative Encyclopedia of Pediatric Imaging, Surgery, and Pathology
The patient was a 15 month old male with a history of opsoclonus and myoclonus which was worked up with a Brain MRI which was unremarkable. A previous body CT from 6 months earlier was negative. The symptoms improved for a while, but have recently worsened.
Clinical Physical Exam:
Opsoclonus and myoclonus
Clinical Differential Diagnosis:
A computed tomography scan of the abdomen and pelvis demonstrated a new midline presacral mass. A bone scan was negative for metastases. An MRI exam of the pelvis performed 1 month after the computed tomography exam showed the mass to be invading the lowest sacral neural foramina on the left side.
Images 2 and 3
Imaging Differential Diagnosis:
Neuroblastoma most likely. Other presacral masses are teratoma, meningocele, rhabdomyosarcoma.
Two weeks after the initial diagnosis the patient was taken to the operating room for transrectal biopsy of the mass, which revealed it to be neuroblastoma. After receiving several cycles of chemotherapy which slightly decreased the size of the tumor, two months after the initial diagnosis, the tumor was surgically removed through a posterior sagittal trans sacral approach.
Examination of the surgical specimen revealed it to have findings characteristic of a neuroblastoma.
Neuroblastoma, Presacral with metastatic spread to the upper sacral lymph nodes.
Follow-up and Prognosis:
The patient had an uncomplicated post-operative course.
Case 41, Case 49
Please send us comments by filling out our Comment Form.
All contents copyright © 1992-2021 Donna M. D'Alessandro, M.D. and Michael P. D'Alessandro, M.D. and the authors. All rights reserved.
"Virtual Pediatric Hospital", the Virtual Pediatric Hospital logo, and "A digital library of pediatric information" are all Trademarks of Donna M. D'Alessandro, M.D. and Michael P. D'Alessandro, M.D.
Virtual Pediatric Hospital is funded in whole by Donna M. D'Alessandro, M.D. and Michael P. D'Alessandro, M.D. Advertising is not accepted.
Your personal information remains confidential and is not sold, leased, or given to any third party be they reliable or not.
The information contained in Virtual Pediatric Hospital is not a substitute for the medical care and advice of your physician. There may be variations in treatment that your physician may recommend based on individual facts and circumstances.