Naseri Mitra, Ashrafzadeh Farah, Faraji Rad Mohammad, Sharifi Nourieh
Pediatric Nephrology Department, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
Pediatric Neurology Department, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
Iran J Child Neurol. 2021 Winter;15(1):119-124. doi: 10.22037/ijcn.v15i2.27793.
Neuroblastic tumors are the most common extracranial solid tumors in children. They are manifested by different clinical presentations ranging from cord compression symptoms to asymptomatic cases. A 2.5-year girl with a history of vaginal delivery at 39 gestational weeks and low Apgar score presented by repeated episodes of urinary tract infections and progressive paraplegia started at the age of 8 months. Brain MRI and EEG were normal. Voiding cystourethrography revealed grade II vesicoureteral reflux in the left kidney. Lumbar MRI with and without contrast showed a dumbbell shape mass, the hyper signal in T2 -weighted image and low signal in T1 -weighted image, extramedullary, and intramural with mass effect on the cord. Microscopic examination of tissue obtained by surgery reported ganglioneuroma. Our case was interesting because of her presentation, neurogenic bladder associated with repeated episodes of urinary tract infections, and secondary paraplegia. Neurogenic bladder dysfunction is rarely reported in cases with ganglioneuroma.
神经母细胞瘤是儿童最常见的颅外实体瘤。它们表现为从脊髓压迫症状到无症状病例等不同的临床表现。一名2.5岁女童,孕39周顺产,阿氏评分低,自8个月大起反复出现尿路感染和进行性截瘫。脑部磁共振成像(MRI)和脑电图正常。排尿性膀胱尿道造影显示左肾二级膀胱输尿管反流。增强和未增强的腰椎MRI显示哑铃形肿块,T2加权像呈高信号,T1加权像呈低信号,位于髓外和壁内,对脊髓有占位效应。手术获取组织的显微镜检查报告为神经节神经瘤。我们的病例很有意思,因其表现、与反复尿路感染相关的神经源性膀胱以及继发性截瘫。神经节神经瘤病例中很少报告神经源性膀胱功能障碍。