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BILATERAL BASAL GANGLIA METASTASIS DUE TO MEDULLOBLASTOMA DIAGNOSED BY ENDOSCOPIC BIOPSY
Case Presentation, Discussion, and Final Comments.
Case presentation: 5-year-old boy who presented with tremor in both hands. No Other complaints. Past Treatment of posterior fossa tumor (Medulloblastoma) with surgery, radiotherapy and chemotherapy.Physical Exam shows tremor in both hands (action and rest) and axial ataxia (sequel due to medulloblastoma). Discussion: Bilateral hiperintensity in basal ganglia. Many etiologic causes as inflamatory or neoplastic could be an option. Endoscopic biopsy of both lesions was performed and the diagnosis of bilateral basal ganglia metastasis was set after histopathologic analisys.Bilateral basal ganglia lesions have many differential diagnosis as lymphoma, ischemia, toxins or infections. The patient did not presented any complications after the surgical procedure. Intravenous and intrathecal chemoteraphy were recommended by neuro-oncology team. Final comments: Patients with past of neoplastic disease must be evaluated for neoplastic spread of the primary tumor. In this case, it is known this particular caractheristic of medulloblastoma. Stereotactic or endoscopic biopsy are great options to achieve this diagnosis. The technique chosen by the surgeon should be guided by his experience.
MARCOS DEVANIR DA SILVA COSTA, EMMANUEL SÁ, PATRÍCIA DASTOLI, JARDEL NICÁCIO, NASJLA SILVA, TALITA HELENA MARTINS SARTI, CAROLINA TORRES SOARES, SERGIO CAVALHEIRO, ANDREA CAPPELLANo