Leukoencephalopathy around a tumor cyst following intracystic methotrexate injection.

Abstract:

:A 4-year-old female with choroid plexus carcinoma developed progressive disturbance of consciousness 2 years after postoperative treatment with radiotherapy, chemotherapy, and focal methotrexate injection into a residual tumor cyst. Magnetic resonance imaging revealed white matter lesions localized around the expanding large cyst. A malignant recurrence of choroid plexus carcinoma with a propensity of cerebrospinal fluid overproduction was suspected. However, daily drainage of cerebrospinal fluid from the cyst and treatment with glycerol and dexamethasone achieved improvement. Diffuse hypoperfusion over the lesions on single-photon emission computed tomography denied the possibility of residual tumor aggravation and together with subsequent atrophic changes confirmed that the lesions reflect localized leukoencephalopathy, possibly associated with methotrexate forced into the parenchyma as a result of the expanding intracystic high pressure.

journal_name

Pediatr Neurol

journal_title

Pediatric neurology

authors

Yano T,Sawaishi Y,Hirayama A,Takaku I,Takada G

doi

10.1016/j.pediatrneurol.2004.06.018

subject

Has Abstract

pub_date

2005-01-01 00:00:00

pages

68-71

issue

1

eissn

0887-8994

issn

1873-5150

pii

S0887-8994(04)00359-5

journal_volume

32

pub_type

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