title: Atypical Teratoid Rhabdoid Tumor in a Teenager with Unusual Infiltration Into the Jugular Foramen.
abstract: BACKGROUND
  Atypical teratoid rhabdoid tumor is a rare malignant neoplasm that represents 1%-2% of all pediatric central nervous system tumors. Immunohistochemistry plays an important role in establishing the diagnosis with a loss of INI-1 staining in tumor cells. In this case report, we describe a teenager with an unusual presentation and pattern of infiltration of the tumor.
  
  
  METHODS
  A 13-year-old boy presented with a history over several months of progressive nausea, weight loss, and hoarseness of voice associated with multiple lower cranial nerve palsies on neurologic examination. Magnetic resonance imaging revealed a large heterogeneously enhancing extra-axial neoplasm with extension and bony expansion of the jugular foramen. After near total resection, neuropathology demonstrated the absence of INI-1 expression consistent with a diagnosis of atypical teratoid rhabdoid tumor.
  
  
  CONCLUSIONS
  This case highlights the diverse clinical presentation and infiltrative potential of atypical teratoid rhabdoid tumors, thus expanding the differential diagnosis of extra-axial tumors invading the jugular foramen.
authors.affiliation: Division of Hematology-Oncology, Department of Pediatrics, University of California, San Diego, Rady Children's Hospital-San Diego, San Diego, California, USA. Electronic address: tudaka@rchsd.org.
authors.forename: Yoko T
authors.initials: YT
authors.lastname: Udaka
authors.affiliation: Division of Hematology-Oncology, Department of Pediatrics, University of California, San Diego, Rady Children's Hospital-San Diego, San Diego, California, USA.
authors.forename: Janet M
authors.initials: JM
authors.lastname: Yoon
authors.affiliation: Department of Pathology, Rady Children's Hospital-San Diego, San Diego, California, USA.
authors.forename: Denise M
authors.initials: DM
authors.lastname: Malicki
authors.affiliation: Department of Radiology, Rady Children's Hospital-San Diego, San Diego, California, USA.
authors.forename: Paritosh C
authors.initials: PC
authors.lastname: Khanna
authors.affiliation: Department of Neurosurgery, Rady Children's Hospital-San Diego, San Diego, California, USA.
authors.forename: Michael L
authors.initials: ML
authors.lastname: Levy
authors.affiliation: Division of Hematology-Oncology, Department of Pediatrics, University of California, San Diego, Rady Children's Hospital-San Diego, San Diego, California, USA; Department of Neurosciences, Rady Children's Hospital-San Diego, San Diego, California, USA.
authors.forename: John R
authors.initials: JR
authors.lastname: Crawford
mesh_terms: D000293:Adolescent; D059248:Chemoradiotherapy; D003131:Combined Modality Therapy; D003389:Cranial Nerve Diseases / Q000209:etiology; D006685:Hoarseness / Q000209:etiology; D006801:Humans; D064795:Intraoperative Neurophysiological Monitoring; D008297:Male; D009325:Nausea / Q000209:etiology; D009361:Neoplasm Invasiveness; D059906:Neuroimaging; D009460:Neurologic Examination; D019635:Neurosurgical Procedures / Q000379:methods*; D018335:Rhabdoid Tumor / Q000473:pathology* / Q000601:surgery*; D019292:Skull Base Neoplasms / Q000473:pathology* / Q000601:surgery*; D016896:Treatment Outcome
keywords: Atypical teratoid rhabdoid tumor; Jugular foramen; Neuroimaging