Resolution of type I Chiari malformation and associated syringomyelia following intrathecal chemotherapy: case report
| Autor: | Jung-Shun Lee, Yi Shan Tsai, Yu Ning Chen, Chia En Wong, Jiann Shiuh Chen |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
Chemotherapy
Foramen magnum medicine.medical_specialty business.industry medicine.medical_treatment Induction chemotherapy General Medicine medicine.disease Lymphoma 03 medical and health sciences 0302 clinical medicine Cerebrospinal fluid medicine.anatomical_structure 030220 oncology & carcinogenesis Cytology Medicine Radiology business 030217 neurology & neurosurgery Type I Chiari malformation Syringomyelia |
| Zdroj: | Journal of Neurosurgery: Pediatrics. 27:145-150 |
| ISSN: | 1933-0715 1933-0707 |
| DOI: | 10.3171/2020.7.peds20411 |
| Popis: | Type I Chiari malformation (CM-I) consists of downward herniation of the cerebellar tonsils below the foramen magnum and often requires surgical decompression if symptomatic. Spontaneous resolution of CM-I is rare. We present a case of resolved CM-I without surgery in a 6-year-old boy with B-cell lymphoma who was diagnosed with CM-I during lymphoma staging. Cerebrospinal fluid cytology and brain MRI revealed negative CNS involvement but showed CM-I with tonsillar ectopia 19 mm below the foramen magnum. The patient underwent induction chemotherapy including 5 doses of intrathecal chemotherapy. Follow-up MRI demonstrated marked regression of CM-I to less than 6 mm in 3 months, and complete resolution of CM-I was observed in 2 years. To the best of our knowledge, this is the first case of resolved CM-I and syringomyelia following chemotherapy. In this case report, the authors summarize all of the clinical characteristics, the radiological appearance, and the potential causes of resolution based on a review of the literature and propose the mechanisms through which intrathecal chemotherapy contributed to the CM-I and syringomyelia resolution in the present case. |
| Databáze: | OpenAIRE |
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