title: Case report: a case of persistent back pain and constipation in a 5-year-old boy.
abstract: Pediatric intramedullary spinal cord tumors are rare and account for 3% to 6% of all central nervous system tumors. Astrocytomas are infiltrating neoplasms, and they predominate in the pediatric population. We report a case of an intramedullary spinal cord astrocytoma in a 5-year-old boy with nonspecific mid-back pain for 3 months. Physical examination revealed clonus, thoracolumbar tenderness, and pain with sitting straight leg raises. An urgent magnetic resonance imaging showed an intramedullary tumor in the mid-thoracic cord, confirmed by surgical excision. The physician should maintain a high index of suspicion when evaluating the pediatric patient who presents with unexplained and persistent back pain. Associated findings, including nocturnal pain and neurological symptoms may indicate a more serious underlying pathology such as a tumor. Early detection, prompt treatment, and proper post surgical management will often lead to improved outcomes in patients.
authors.affiliation: Children's Hospital Boston, Havard Medical School, Boston, MA 02115, USA. michael.obrien@childrens.harvard.edu
authors.forename: Michael
authors.initials: M
authors.lastname: O'Brien
authors.forename: Christine
authors.initials: C
authors.lastname: Curtis
authors.forename: Pierre
authors.initials: P
authors.lastname: D'Hemecourt
authors.forename: Mark
authors.initials: M
authors.lastname: Proctor
mesh_terms: D001254:Astrocytoma / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D001416:Back Pain / Q000209:etiology*; D002675:Child, Preschool; D003248:Constipation / Q000209:etiology*; D003937:Diagnosis, Differential; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D013120:Spinal Cord Neoplasms / Q000150:complications* / Q000175:diagnosis / Q000601:surgery