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KMID : 0942820070060020129
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Journal of Korean Brain Tumor Society
2007 Volume.6 No. 2 p.129 ~ p.132
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Spontaneous Intracerebral Hemorrhage due to Occult CNS Metastatic Neuroblastoma
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Baek Hyun-Chul
Jin Sung-Chul
Ahn Jae-Sung
Kwun Byung-Duk
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Abstract
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Neuroblastoma is the one of the most common solid tumors in pediatric oncology. The long-term survival of patients with advanced stage neuroblastoma has remarkably improved secondary to aggressive treatment protocols including autologous bone marrow transplantation(BMT). The central nervous system(CNS), once a rare site of disease, is becoming involved with increasing frequency. However, here we present an unusual case of acute intracerebral hemorrhage in a child with stage IV neuroblastoma, in which follow-up radiological imaging had not revealed involvement of the brain parenchyma or leptomeninge. A 27 month-old boy, who had been diagnosed with stage IV neuroblastoma, developed right hemiparesis and decreased consciousness abruptly ten months after diagnosis. Brain computed tomography revealed left temporal intracerebral hemorrhage(ICH) which had to be removed by emergency operation as soon as possible. Previous follow-up studies had not shown parenchymal or leptomeningeal involvement. Emergency craniotomy of the left temporal lesion demonstrated no dura invasion with an underlying massive cortical hemorrhage that did not involve a definite tumor mass. Even so, the hemorrhage was biopsied for the confirmation of brain metastasis. Metastatic neuroblastoma was histologically confirmed.
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KEYWORD
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Neuroblastoma, Central nervous system, Intracerebral hemorrhage
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