Effective radiotherapy cured cauda equina syndrome caused by remitted intracranial germinoma depositing.
Cauda equina syndrome (CES) in children is very rare and can permanently disable. A remitted intracranial germinoma depositing on the spinal cord, leading to CES, has never been reported. We discuss the case of a 10-year-old girl who presented with sudden ataxia, low back pain, sensory deficits of the left lower extremity, and difficulty urinating and defecating 7 months after totally remitted intracranial germinoma postintracranial surgery and cranial irradiation. Magnetic resonance imaging (MRI) of the brain and spine showed multiple intradural extramedullary homogeneous masses from the cervical to lumbar levels, compressing the conus medullaris and cauda equina. After emergent craniospinal irradiation, the patient's neurologic symptoms dramatically subsided. A remitted intracranial germinoma depositing on her spinal cord could be the cause of CES. Early identification and a proper craniospinal irradiation may halt the progression of symptoms.
Department of Pediatrics, Tri-Service General Hospital, Taipei, Taiwan.
Ying-Chun
YC
Lu
Hueng-Chuen
HC
Fan
Hong-Wei
HW
Gao
Chang-Ming
CM
Chen
Yee-Min
YM
Jen
Shin-Nan
SN
Cheng
Shyi-Jou
SJ
Chen
D001707:Biopsy, Needle; D001932:Brain Neoplasms / Q000473:pathology* / Q000532:radiotherapy* / Q000601:surgery; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D018237:Germinoma / Q000473:pathology / Q000532:radiotherapy* / Q000556:secondary* / Q000601:surgery; D006801:Humans; D007150:Immunohistochemistry; D017116:Low Back Pain / Q000175:diagnosis / Q000209:etiology; D008279:Magnetic Resonance Imaging / Q000379:methods; D011128:Polyradiculopathy / Q000209:etiology / Q000473:pathology / Q000532:radiotherapy*; D035583:Rare Diseases; D018570:Risk Assessment; D013125:Spinal Neoplasms / Q000473:pathology / Q000532:radiotherapy / Q000556:secondary*; D016896:Treatment Outcome