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Updated: Nov 1, 2025
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A Case of Pediatric Stroke: Osteosarcoma Embolus in the Internal Carotid Artery
Christopher Troy1, Jonathan Sisti1, Angel Maldonado-Soto2
1Department of Neurosurgery, Columbia University Irving Medical Center, New York, New York, USA.
Insights
Pediatric stroke, though rare, can mimic adult stroke and be misdiagnosed. This case highlights a rare cause: osteosarcoma tumor embolus, emphasizing unique treatment challenges in children.
Area of Science:
- Neurology
- Pediatric Oncology
- Vascular Medicine
Background:
- Pediatric stroke is uncommon, often presenting similarly to adult stroke but frequently misdiagnosed.
- Optimal treatment strategies for pediatric stroke are not well-established due to a lack of clinical trials.
Observation:
- This report details a rare case of pediatric stroke caused by an osteosarcoma tumor embolus.
- The embolism affected the left internal carotid artery in a young child.
Findings:
- Diagnosis of pediatric stroke can be challenging, with potential for confusion with stroke mimics.
- Treatment guidelines are often adapted from adult protocols, including thrombolysis and mechanical thrombectomy.
Implications:
- This case underscores the importance of considering rare etiologies, such as tumor emboli, in pediatric stroke.
- Further research is needed to refine treatment protocols for pediatric stroke, especially for complex cases like tumor embolisms.
Abstract:
Stroke in the pediatric population is rare. Despite presentation similar to that seen in the adult patient, the diagnosis in a child can be missed or mistaken for a more common stroke mimic. Due to its rarity, there are no completed pediatric clinical trials investigating best treatment, though guidelines have been extrapolated from adult guidelines and retrospective cohort studies to include some combination of thrombolysis and mechanical thrombectomy. Rarer still is pediatric stroke caused by tumor embolus. We present the case of a young child diagnosed with stroke secondary to osteosarcoma embolism to the left internal carotid artery and review the relevant literature to discuss the considerations and challenges of treatment of stroke in the pediatric population.
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