• Yoko T Udaka, Janet M Yoon, Denise M Malicki, Paritosh C Khanna, Michael L Levy, and John R Crawford.
• Division of Hematology-Oncology, Department of Pediatrics, University of California, San Diego, Rady Children's Hospital-San Diego, San Diego, California, USA. Electronic address: tudaka@rchsd.org.
• World Neurosurg. 2015 Dec 1;84(6):2075.e13-6.

BackgroundAtypical teratoid rhabdoid tumor is a rare malignant neoplasm that represents 1%-2% of all pediatric central nervous system tumors. Immunohistochemistry plays an important role in establishing the diagnosis with a loss of INI-1 staining in tumor cells. In this case report, we describe a teenager with an unusual presentation and pattern of infiltration of the tumor.Case DescriptionA 13-year-old boy presented with a history over several months of progressive nausea, weight loss, and hoarseness of voice associated with multiple lower cranial nerve palsies on neurologic examination. Magnetic resonance imaging revealed a large heterogeneously enhancing extra-axial neoplasm with extension and bony expansion of the jugular foramen. After near total resection, neuropathology demonstrated the absence of INI-1 expression consistent with a diagnosis of atypical teratoid rhabdoid tumor.ConclusionsThis case highlights the diverse clinical presentation and infiltrative potential of atypical teratoid rhabdoid tumors, thus expanding the differential diagnosis of extra-axial tumors invading the jugular foramen.Copyright © 2015 Elsevier Inc. All rights reserved.

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