title: A case of Cushing ulcer in an 8-month-old patient with medulloblastoma.
abstract: The authors present the first case of a Cushing ulcer in an infant with medulloblastoma who, despite being administered stress ulcer prophylaxis, worsened after corticosteroids were initiated. An 8-month-old boy presented with progressive vomiting, lethargy, and decreased oral intake. Imaging revealed a heterogeneous fourth ventricular mass. Preoperatively, the patient was started on dexamethasone. The patient underwent an uncomplicated external ventricular drain placement and suboccipital craniotomy for resection of the lesion. The results of the pathological analysis were consistent with medulloblastoma. Postoperatively, the patient had melanotic stools, which were reported to be occurring for months prior to presentation. Two proximal duodenal bulb ulcers were found and required definitive surgical repair. The patient recovered from the acute postsurgical course after continued stress ulcer prophylaxis and is currently undergoing chemotherapy.
authors.affiliation: 1 Department of Neurosurgery, Division of Pediatric Neurosurgery, 2 Department of Surgery, Division of Pediatric Surgery, Primary Children's Hospital, University of Utah, Salt Lake City, Utah, USA.
authors.forename: Walavan
authors.initials: W
authors.lastname: Sivakumar
authors.affiliation: 1 Department of Neurosurgery, Division of Pediatric Neurosurgery, 2 Department of Surgery, Division of Pediatric Surgery, Primary Children's Hospital, University of Utah, Salt Lake City, Utah, USA.
authors.forename: Heather S
authors.initials: HS
authors.lastname: Spader
authors.affiliation: 1 Department of Neurosurgery, Division of Pediatric Neurosurgery, 2 Department of Surgery, Division of Pediatric Surgery, Primary Children's Hospital, University of Utah, Salt Lake City, Utah, USA.
authors.forename: Eric
authors.initials: E
authors.lastname: Scaife
authors.affiliation: 1 Department of Neurosurgery, Division of Pediatric Neurosurgery, 2 Department of Surgery, Division of Pediatric Surgery, Primary Children's Hospital, University of Utah, Salt Lake City, Utah, USA.
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Bollo
keywords: Cushing ulcer; medulloblastoma; neurosurgery; stress ulcer