Abstract Ref Number = APCP1110
Unusual Presentation of A Large Intraventricular Brain Tumor in A Child
Klinik Pratama Alam Sehat Lestari
Background : Twenty percent of brain tumors happened in childhood. Awareness of signs and symptoms would help early diagnosis to prevent poor outcomes. The location of a tumor may impact the clinical presentation. Intraventricular locations occur rarely, making up 6.3 percent of all brain tumors in children. Most children may complain early of headache, nausea, and vomiting especially in the morning, because of increasing intracranial pressure.
Case Presentation Summary : A 10 year old boy presented with gradual weakness on the right side in both upper and lower extremity and early secondary sexual development (Tanner 3). The patient had not had any neuroimaging procedure. In nine months the symptoms developed into deficits of the left 3rd, 7th, and 12th cranial nerves, loss of control of urination and defecation, severe thirst, and memory disturbance. There were no symptoms of headache, nausea, vomiting, double vision, or seizure, and no trauma history. The patient got worked up with brain MRI in which T1-weighted images showed a large intraventricular brain mass located in the left lateral ventricle. The mass compressed the third ventricle and frontal brain, and also caused a midline shift to the right. The mass was excised and later confirmed as an atypical meningioma (WHO grade II tumor).
Learning Points/Discussion : The early clinical manifestations of intraventricular brain tumors in children may not always be headache, vomiting, or other symptoms of increasing intracranial pressure, but gradual neural deficits with precocious puberty may also be an early sign. Neuroimaging should be considered for early diagnosis of unusual brain tumors.
Keywords: Intraventricular tumor Pediatric tumor Unusual presentation Precocious puberty