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Spinal Astrocytoma with Brachial Plexus-like Presentation: A Report of 2 Cases

Keenan Sobol1, Scott Kozin2, Natalie Williams2

  • 1Department of Orthopaedic Surgery, Jefferson Einstein Hospital, Philadelphia, Pennsylvania.

JBJS Case Connector
|June 5, 2026
PubMed

Insights

Spinal astrocytoma in infants can mimic brachial plexus birth injuries (BPBI). Early suspicion of spinal tumors is crucial for accurate diagnosis and timely treatment in infants with suspected BPBI.

Area of Science:

  • Pediatric Neurology
  • Pediatric Neurosurgery
  • Pediatric Oncology

Background:

  • Brachial plexus birth injuries (BPBI) are common in newborns, presenting with upper extremity weakness.
  • Spinal cord tumors, such as astrocytoma, can present with similar symptoms in infants, leading to diagnostic challenges.

Purpose of the Study:

  • To highlight the potential misdiagnosis of spinal astrocytoma as BPBI in infants.
  • To emphasize the importance of considering spinal neoplasms in infants with unexplained neurological deficits resembling BPBI.

Main Methods:

  • Case report of two infants diagnosed with spinal astrocytoma.
  • Diagnostic workup included magnetic resonance imaging (MRI) and biopsy.
  • Treatment involved chemotherapy, spinal decompression, and proton therapy.

Main Results:

  • Case 1: A 5-month-old infant with cervical astrocytoma showed partial recovery after chemotherapy.
  • Case 2: A 5-month-old infant with pilocystic astrocytoma did not regain function despite spinal decompression and proton therapy.

Conclusions:

  • A high index of suspicion for spinal tumors is essential when evaluating infants with suspected BPBI.
  • Timely diagnosis and treatment of spinal astrocytoma can improve outcomes in pediatric patients.
Abstract

Keywords:
Brachial plexusMRI findingsastrocytomadecreased range of motioninfant

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