Rapidly progressive medulloblastoma initially mimicking idiopathic intracranial hypertension and Chiari I malformation: A case report

Raywat Noiphithak; Nattakitta Mektripop; Chatchai Thamwongskul

doi:10.1016/j.ijscr.2021.106147

Rapidly progressive medulloblastoma initially mimicking idiopathic intracranial hypertension and Chiari I malformation: A case report

Int J Surg Case Rep. 2021 Aug:85:106147. doi: 10.1016/j.ijscr.2021.106147. Epub 2021 Jun 29.

Authors

Raywat Noiphithak¹, Nattakitta Mektripop², Chatchai Thamwongskul³

Affiliations

¹ Division of Neurosurgery, Department of Surgery, Thammasat University Hospital, Faculty of Medicine, Thammasat University, Pathumthani, 95 Phahonyothin Rd., Klongnueng, Klongluang, Pathumthani 12120, Thailand. Electronic address: raywat_n@tu.ac.th.
² Division of Neurosurgery, Department of Surgery, Thammasat University Hospital, Faculty of Medicine, Thammasat University, Pathumthani, 95 Phahonyothin Rd., Klongnueng, Klongluang, Pathumthani 12120, Thailand.
³ Department of Pathology and Forensic Medicine, Thammasat University Hospital, Faculty of Medicine, Thammasat University, Pathumthani, 95 Phahonyothin Rd., Klongnueng, Klongluang, Pathumthani 12120, Thailand.

Abstract

Introduction: Medulloblastoma (MDB) often causes signs and symptoms of elevated intracranial pressure (ICP) with imaging findings of mass lesion. Here, we report a case of MDB who initially presented with clinical features imitating idiopathic intracranial hypertension (IIH) and Chiari I malformation (CIM).

Case presentation: A 19-year-old man had clinical symptoms of elevated ICP without mass lesion on imaging. He was initially diagnosed with IIH and CIM, which underwent shunt surgery and posterior fossa decompression. Later on, he had recurrent symptoms, and the new imaging revealed the development of MDB in the right cerebellar hemisphere. After tumor resection, the patient rapidly deteriorated with spinal metastases.

Discussion and conclusion: Management of the coexistence between IIH and CIM in patients with rising ICP is complicated. MDB is one of the aggressive malignant brain tumors showing a wide range of imaging features, including non-enhancing mass. Therefore, recognizing the possibility of brain tumors mimicking IIH or CIM is crucial.

Keywords: Chiari; Idiopathic intracranial hypertension; Medulloblastoma.