Subject(s)
Cerebellar Neoplasms , Medulloblastoma , Humans , Medulloblastoma/radiotherapy , Medulloblastoma/secondary , Cerebellar Neoplasms/radiotherapy , Cerebellar Neoplasms/secondary , Cerebellar Neoplasms/diagnostic imaging , Diagnosis, Differential , Adolescent , Male , Radiation Injuries/etiology , Radiation Injuries/diagnosisSubject(s)
Magnetic Resonance Imaging , Neoplasms, Germ Cell and Embryonal , Pineal Gland , Humans , Neoplasms, Germ Cell and Embryonal/diagnostic imaging , Neoplasms, Germ Cell and Embryonal/pathology , Pineal Gland/pathology , Pineal Gland/diagnostic imaging , Male , Brain Neoplasms/diagnostic imaging , Brain Neoplasms/pathology , Neuroimaging/methods , Child , Pinealoma/diagnostic imaging , Pinealoma/pathology , Testicular NeoplasmsSubject(s)
Ependymoma , Infratentorial Neoplasms , Radiation Injuries , Adolescent , Humans , Cerebrovascular Disorders/etiology , Cerebrovascular Disorders/diagnostic imaging , Diagnosis, Differential , Ependymoma/radiotherapy , Infratentorial Neoplasms/radiotherapy , Infratentorial Neoplasms/diagnostic imaging , Magnetic Resonance Imaging , Radiation Injuries/etiology , Radiation Injuries/diagnosisSubject(s)
Sarcoma , Humans , DEAD-box RNA Helicases/genetics , Mutation , Ribonuclease III/genetics , Female , AdolescentABSTRACT
The opioid epidemic has become a significant public health crisis worldwide. With the rise in popularity of fentanyl, opioid overdoses continue to rise at unprecedented rates. Unfortunately, young children have become collateral damage in the face of the opioid epidemic. Accidental exposures and ingestions are the leading cause of opioid overdose in this age group and can result in significant acute complications, long-term sequelae and even death. We present the case of a toddler with accidental fentanyl ingestion who experienced seizures and required intubation for respiratory distress. He was found to have notable diffusion restriction cerebellar changes on MRI and ultimately discharged with normal neurological function. Our case adds to the growing literature of the clinical presentation and neuroimaging features associated with opioid toxicity in young children.
Subject(s)
Opiate Overdose , Male , Humans , Child, Preschool , Neuroimaging , Disease Progression , Analgesics, Opioid , FentanylSubject(s)
Astrocytoma , Brain Neoplasms , Supratentorial Neoplasms , Humans , Adolescent , Proto-Oncogene Proteins B-raf/genetics , Astrocytoma/diagnostic imaging , Astrocytoma/genetics , Brain Neoplasms/diagnostic imaging , Brain Neoplasms/genetics , Mutation , Phosphotransferases (Alcohol Group Acceptor)/geneticsSubject(s)
Central Nervous System Neoplasms , Ependymoma , Neoplasms, Neuroepithelial , Humans , Adolescent , Neoplasms, Neuroepithelial/genetics , Transcription Factors/genetics , Ependymoma/genetics , Ependymoma/surgery , Gene Fusion , Repressor Proteins/genetics , Kruppel-Like Transcription Factors/genetics , RNA-Binding Protein EWS/geneticsSubject(s)
Brain Neoplasms , Glioma , Humans , Child , Child, Preschool , Glioma/diagnostic imaging , Brain Neoplasms/diagnostic imagingABSTRACT
We present 4 children (diagnosed between 1 and 8 y, 3 females and 1 male) with molecularly distinct tectal gliomas (2 KRAS mutant, 1 EGFR mutant, 1 SRGAP3-RAF-1 fusion) that contributes to the growing literature of this uncommonly biopsied tumor. The patient with EGFR R222C mutation had a more severe course, earlier diagnosis, subsequent leptomeningeal metastatic disease, required more aggressive therapies, and died 9 years after diagnosis. Patients with KRAS mutations and SRGAP3-RAF-1 fusion had a more indolent course. Our series expands the molecular phenotype of tectal glioma with the potential for leptomeningeal dissemination. Future studies on establishing genotypic/phenotypic correlation from those who undergo biopsy are needed.