Asia Oceania Journal of Nuclear Medicine and Biology

Asia Oceania Journal of Nuclear Medicine and Biology

Neuroblastoma-related severe hypoperfusion in the cerebellum of an infant: A case of opsoclonus-myoclonus syndrome

Document Type : Case report

Authors
Junki Takenaka 1, 2
Kenji Hirata 1, 2, 3
Shiro Watanabe 1, 2, 3
Hideaki Shiraishi 4
Kudo Kohsuke 1, 5, 3
1 Department of Diagnostic Imaging, Graduate School of Medicine, Hokkaido University, Sapporo, Japan
2 Department of Nuclear Medicine, Hokkaido University Hospital, Sapporo, Japan
3 Global Center for Biomedical Science and Engineering, Faculty of Medicine, Hokkaido University, Sapporo, Japan
4 Department of Pediatrics, Graduate School of Medicine, Hokkaido University, Sapporo, Japan
5 Department of Diagnostic and Interventional Radiology, Hokkaido University Hospital, Sapporo, Japan
10.22038/aojnmb.2022.65833.1459
Abstract
A 2-year-old girl started to wobble without any specific triggers, so the patient was admitted to our hospital's pediatric department. The entire cerebellum showed severe atrophy on MRI and much lower uptake than that in the cerebral cortex on perfusion SPECT. The diagnosis of opsoclonus-myoclonus syndrome (OMS) was suspected. MRI visualized a small mass behind the inferior vena cava. Although its uptake on I-123 MIBG scintigraphy was inconclusive, the mass was surgically removed, and the diagnosis of neuroblastoma was pathologically confirmed. OMS is one of the paraneoplastic neurological syndromes with cerebellar ataxia, myoclonus of the trunk and extremities, and opsoclonus as its main symptoms. Approximately 50% of children cases with OMS are associated with neuroblastoma. The prognosis for neuroblastoma itself with OMS is relatively good, but the neurological prognosis is very poor. If there is decreased blood flow in the cerebellum of an infant, it may be necessary to search for neuroblastoma.
Keywords
Opsoclonus-myoclonus syndrome
Neuroblastoma
Brain perfusion SPECT
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Asia Oceania Journal of Nuclear Medicine and Biology
Volume 11, Issue 1
January 2023
Pages 93-96