title: Long-term survival of an infant with diffuse brainstem lesion diagnosed by prenatal MRI: a case report and review of the literature.
abstract: BACKGROUND
  We describe a unique case of expansive diffuse brainstem lesion diagnosed prenatally by magnetic resonance imaging (MRI) with long-term survival. Findings of fetal and postpartum MRI were highly consistent with the characteristics of diffuse brainstem glioma.
  
  
  METHODS
  Diagnosis was based on the features of MRI, and histopathology was not confirmed by biopsy. Although the prognosis of diffuse brainstem tumor is usually poor, this child was asymptomatic at birth and the neurological condition is still normal at 4 years of age without any treatment.
  
  
  RESULTS
  During routine imaging follow-up, diameters of the expansion have remained stable, while the size of the lesion compared to the posterior fossa size has diminished. In addition to brainstem tumor, a skin lesion of the back was observed and MRI of the thoracic spine showed a large asymptomatic extradural cystic lesion suggesting an arachnoid cyst. The pontine tumor of this infant, in agreement with a few previously reported cases, suggests a subgroup of beneficial outcome of expansive diffuse brainstem lesions, particularly in the neonatal period.
  
  
  CONCLUSIONS
  In this article, we discuss the prognosis and characteristics of pediatric brainstem tumors and differential diagnosis of neonatal brainstem lesions.
authors.affiliation: Department of Diagnostic Radiology, Oulu University Hospital and University of Oulu, P.O. Box 50, 90029, OYS, Oulu, Finland. maria.suo-palosaari@fimnet.fi.|Medical Research Center, University of Oulu, Oulu, Finland. maria.suo-palosaari@fimnet.fi.
authors.forename: M
authors.initials: M
authors.lastname: Suo-Palosaari
authors.affiliation: Department of Children and Adolescents, Oulu University Hospital, Oulu, Finland.|PEDEGO Research Group, Medical Research Center, University of Oulu, Oulu, Finland.
authors.forename: H
authors.initials: H
authors.lastname: Rantala
authors.affiliation: Department of Children and Adolescents, Oulu University Hospital, Oulu, Finland.|PEDEGO Research Group, Medical Research Center, University of Oulu, Oulu, Finland.
authors.forename: S
authors.initials: S
authors.lastname: Lehtinen
authors.affiliation: Medical Research Center, University of Oulu, Oulu, Finland.|Department of Neurosurgery, Oulu University Hospital, P.O. Box 21, 90029, OYS, Oulu, Finland.
authors.forename: T
authors.initials: T
authors.lastname: Kumpulainen
authors.affiliation: Medical Research Center, University of Oulu, Oulu, Finland.|Department of Neurosurgery, Oulu University Hospital, P.O. Box 21, 90029, OYS, Oulu, Finland.
authors.forename: N
authors.initials: N
authors.lastname: Salokorpi
mesh_terms: D000328:Adult; D001933:Brain Stem / Q000293:injuries* / Q000473:pathology*; D020295:Brain Stem Neoplasms / Q000000981:diagnostic imaging* / Q000209:etiology; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007037:Hypothyroidism / Q000000981:diagnostic imaging / Q000188:drug therapy; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging; D011247:Pregnancy; D012867:Skin / Q000473:pathology; D013116:Spinal Cord / Q000000981:diagnostic imaging / Q000473:pathology; D013974:Thyroxine / Q000627:therapeutic use
chemical_list: D013974:Thyroxine
keywords: Arachnoid cysts; Brain stem tumor; Glioma; Prenatal diagnosis; Prognosis