Postoperative hemicerebellar inflammation mimicking recurrent tumor after resection of a medulloblastoma. Case report.
The authors present the case of a 4-year-old boy in whom a medulloblastoma in the left cerebellar hemisphere was successfully resected with no signs of residual tumor on the postoperative magnetic resonance (MR) images. A second MR imaging study performed 1 month after surgery demonstrated an extensive, contrast-enhancing lesion in the left cerebellar hemisphere, which simulated massive recurrent tumor, and repeated surgery was considered. A third postoperative MR imaging study, performed for evaluation of the craniospinal axis 10 days after the second postoperative study, still showed some contrast enhancement in the left cerebellar hemisphere, but the lesion had almost disappeared. Postoperative hemicerebellar inflammation seemed to be the most likely explanation. This case illustrates that early postoperative inflammation can mimic recurrent tumor on MR images obtained after resection of a medulloblastoma and caution should be taken in interpreting such images. Clinical history, neurological examination, laboratory findings, and repeated MR imaging studies can be helpful in evaluating the patient accurately.
Luijnenburg
Saskia E
SE
Department of Pediatrics, Wilhelmina Children's Hospital/University Medical Center Utrecht, The Netherlands.
Hanlo
Patrick W
PW
Han
K Sen
KS
Kors
Wijnanda A
WA
Witkamp
Theo D
TD
Verbeke
Jonathan I M L
JI
D001932:Brain Neoplasms / Q000601:surgery*; D002675:Child, Preschool; D003937:Diagnosis, Differential; D006801:Humans; D007249:Inflammation / Q000175:diagnosis; D008279:Magnetic Resonance Imaging; D008297:Male; D008527:Medulloblastoma / Q000601:surgery*; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis*; D011183:Postoperative Complications