Paediatric Horner Syndrome: How much further to investigate?

Area of Science:

• Pediatric Oncology
• Nuclear Medicine
• Neurology

Background:

• Horner syndrome in infants can be challenging to diagnose.
• Idiopathic acquired pediatric Horner syndrome requires thorough investigation.

Observation:

• An infant presented with early-onset Horner syndrome.
• Urinary catecholamine levels were notably normal.
• Nuclear medicine imaging was performed.

Findings:

• A meta-iodo benzyl-guanidine (MIBG) scan revealed a right thoracic inlet mass.
• The mass was consistent with neuroblastoma, a neural crest tumor.
• ¹²³I-MIBG imaging confirmed the diagnosis.

Implications:

• This case underscores the importance of investigating pediatric Horner syndrome.
• ¹²³I-MIBG scans are valuable for diagnosing suspected neuroblastoma.
• Early detection of neuroblastoma through advanced imaging is critical.