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Spinal cord astrocytoma presenting as torticollis and scoliosis
A Bussieres1, J D Cassidy, A Dzus
1Canadian Memorial Chiropractic College, Toronto, Ontario.
Objective:
To illustrate the importance of a careful differential diagnosis in children presenting with torticollis.
Clinical Features:
A 14-yr-old boy presented with a 6-month history of neck pain, torticollis and increasing neurological deficit. Past physiotherapy and chiropractic treatment had not helped. A myelogram and MRI scan revealed a large intramedullary lesion.
Intervention And Outcome:
He was treated by laminectomy with partial excision of the lesion, followed by radiotherapy. Pathology confirmed the diagnosis of astrocytoma. The patient developed postlaminectomy instability and required spinal fusion.
Conclusion:
The differential diagnosis of torticollis in children is extensive and should always include spinal tumor.