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Long-term survival of an infant with diffuse brainstem lesion diagnosed by prenatal MRI: a case report and review of the literature

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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.

Discussion

In this article, we discuss the prognosis and characteristics of pediatric brainstem tumors and differential diagnosis of neonatal brainstem lesions.

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Author information

Authors and Affiliations

  1. Department of Diagnostic Radiology, Oulu University Hospital and University of Oulu, P.O. Box 50, 90029, OYS, Oulu, Finland

    M. Suo-Palosaari

  2. Medical Research Center, University of Oulu, Oulu, Finland

    M. Suo-Palosaari, T. Kumpulainen & N. Salokorpi

  3. Department of Children and Adolescents, Oulu University Hospital, Oulu, Finland

    H. Rantala & S. Lehtinen

  4. PEDEGO Research Group, Medical Research Center, University of Oulu, Oulu, Finland

    H. Rantala & S. Lehtinen

  5. Department of Neurosurgery, Oulu University Hospital, P.O. Box 21, 90029, OYS, Oulu, Finland

    T. Kumpulainen & N. Salokorpi

Authors
  1. M. Suo-Palosaari
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  2. H. Rantala
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  3. S. Lehtinen
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  4. T. Kumpulainen
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  5. N. Salokorpi
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Corresponding author

Correspondence to M. Suo-Palosaari.

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All authors declare that they have no conflicts of interest regarding the subject of this manuscript and disclose that they have received no financial support. The authors also declare that they have strictly followed the ethical guidelines of Oulu University Hospital and the Helsinki Declaration.

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Suo-Palosaari, M., Rantala, H., Lehtinen, S. et al. Long-term survival of an infant with diffuse brainstem lesion diagnosed by prenatal MRI: a case report and review of the literature. Childs Nerv Syst 32, 1163–1168 (2016). https://doi.org/10.1007/s00381-016-3045-y

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  • DOI: https://doi.org/10.1007/s00381-016-3045-y

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