Unusual clinical presentation of astrocytoma in an adult.
BACKGROUND
Brainstem gliomas have a varied biological behavior based upon histopathological characteristics, localization and related diseases. The objective of this study is to present the clinical case of a grade II (diffuse) astrocytoma in an adult with an atypical clinical presentation including initial hiccup and dysphagia in a patient without evidence of clinical primary gastroenterology pathology.


METHODS
We describe the case of a 51-year-old male with a 4-year history of hiccup, oropharyngeal dysphagia and neurological clinical elements of tongue fasciculations, quadriparesis, generalized hyperreflexia due to astrocytoma with atypical localization in the floor of the fourth ventricle and histopathological diagnosis of low-grade diffuse glioma.


CONCLUSIONS
Hiccup is a nonspecific symptom infrequently associated with neurological disorders. Adequate semiology of oropharyngeal dysphagia would help us to identify neurological entities such as in the case presented here. Additionally, with signs of upper and lower motor neuron we should suspect the possibility of central nervous system abnormalities of functional and organic etiology. Computed axial tomography and magnetic resonance imaging studies are important elements for diagnosis.
Departamento de Enseñanza Clínica e Investigación, Hospital General Regional No.1, Instituto Mexicano del Seguro Social, Morelia, Michoacán, México. cortes.med@hotmail.com
Julio César
JC
Cortés-Medina
Carlos Alberto
CA
Guerrero-Rascón
D001254:Astrocytoma / Q000175:diagnosis*; D001932:Brain Neoplasms / Q000175:diagnosis*; D006801:Humans; D008297:Male; D008875:Middle Aged