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Journal of Pediatric Neurology 2020; 18(04): 195-197
DOI: 10.1055/s-0039-1698428
Case Report
Georg Thieme Verlag KG Stuttgart · New York

Thoracic Endodermal Sinus Tumor with Root Compression Mimicking Guillain–Barre Syndrome in Clinical Presentation, CSF Studies, and EMG/NCV Findings

Gal Barbut
1   Department of Pediatrics, Infants and Children's Hospital of Brooklyn, Maimonides Medical Center, Brooklyn, New York, United States
,
Yuri Brosgol
1   Department of Pediatrics, Infants and Children's Hospital of Brooklyn, Maimonides Medical Center, Brooklyn, New York, United States
2   Division of Child Neurology, Infants and Children's Hospital of Brooklyn, Maimonides Medical Center, Brooklyn, New York, United States
,
Mahmut Celiker
1   Department of Pediatrics, Infants and Children's Hospital of Brooklyn, Maimonides Medical Center, Brooklyn, New York, United States
3   Division of Pediatric Hematology-Oncology, Infants and Children's Hospital of Brooklyn, Maimonides Medical Center, Brooklyn, New York, United States
,
Evan G. Stein
4   Department of Radiology (Neuroradiology), Infants and Children's Hospital of Brooklyn, Maimonides Medical Center, Brooklyn, New York, United States
,
Gary N. McAbee
1   Department of Pediatrics, Infants and Children's Hospital of Brooklyn, Maimonides Medical Center, Brooklyn, New York, United States
2   Division of Child Neurology, Infants and Children's Hospital of Brooklyn, Maimonides Medical Center, Brooklyn, New York, United States
› Author Affiliations
Further Information

Publication History

21 December 2018

18 June 2019

Publication Date:
18 October 2019 (online)

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Abstract

A 2-year-old boy who presented with clinical, cerebrospinal fluid, and electrophysiological findings consistent with Guillain–Barre syndrome (GBS) was found to have a thoracic spinal cord mass due to a yolk sac tumor. On examination, he had an absent anal wink and flaccid anal ring which is atypical for GBS. This case demonstrates the need for a thorough physical examination on presentation of a child with a clinical and laboratory presentation of GBS and highlights the importance of prompt imaging studies when clinical suspicion arises because of atypical clinical signs, such as absent anal wink or low rectal tone.

Keywords

Guillain–Barre syndrome - endodermal sinus tumor - yolk sac tumor - cerebrospinal fluid - electromyography/nerve conduction velocity - Langerhans cell histiocytosis

Authors' Contributions

G.B. authored the first draft of the manuscript and contributed to the literature review of the article. G.N.M., Y.B., M.C., and E.G.S. participated in the care of the patient and contributed to the literature review and text of the article.


 

  • References

  • 1 Jones Jr HR. Guillain-Barré syndrome: perspectives with infants and children. Semin Pediatr Neurol 2000; 7 (02) 91-102
    CrossrefPubMedSearch in Google Scholar
  • 2 Korinthenberg R, Schessl J, Kirschner J. Clinical presentation and course of childhood Guillain-Barré syndrome: a prospective multicentre study. Neuropediatrics 2007; 38 (01) 10-17
    Thieme ConnectPubMedSearch in Google Scholar
  • 3 Osuntokun BO, Agbebi K. Prognosis of Guillain-Barré syndrome in the African: the Nigerian experience. J Neurol Neurosurg Psychiatry 1973; 36 (03) 478-483
    CrossrefPubMedSearch in Google Scholar
  • 4 Mulkey SB, Glasier CM, El-Nabbout B. , et al. Nerve root enhancement on spinal MRI in pediatric Guillain-Barré syndrome. Pediatr Neurol 2010; 43 (04) 263-269
    CrossrefPubMedSearch in Google Scholar
  • 5 Gücüyener K, Keskil S, Baykaner MK, Bilir E, Oğuz A, Ceviker N. Co-incidence of Guillain-Barré syndrome and spinal cord compression in non-Hodgkin lymphoma. Neuropediatrics 1994; 25 (01) 36-38
    Thieme ConnectPubMedSearch in Google Scholar
  • 6 Paraskevopoulos D, Magras I, Polyzoidis K. Spontaneous spinal epidural hematoma secondary to extradural arteriovenous malformation in a child: a case-based update. Childs Nerv Syst 2013; 29 (11) 1985-1991
    CrossrefPubMedSearch in Google Scholar
  • 7 Kim HS, Yun DH, Chon J, Lee JE, Park MH, Han YJ. Syringomyelia coexisting with Guillain-Barre syndrome. Ann Rehabil Med 2013; 37 (05) 745-749
    CrossrefPubMedSearch in Google Scholar
  • 8 Belkouch A, Mouhsine A, Sirbou R. , et al. Spinal hydatidosis mimicking Guillain Barre syndrome: in case of doubt there is no rush to perform lumbar puncture. Pan Afr Med J 2014; 19: 348-349
    PubMedSearch in Google Scholar
  • 9 Poynter JN, Amatruda JF, Ross JA. Trends in incidence and survival of pediatric and adolescent germ cell tumors in the United States, 1975 to 2006. Cancer 2010; 116 (20) 4882-4891
    CrossrefPubMedSearch in Google Scholar
  • 10 Frazier AL, Hale JP, Rodriguez-Galindo C. , et al. Revised risk classification for pediatric extracranial germ cell tumors based on 25 years of clinical trial data from the United Kingdom and United States. J Clin Oncol 2015; 33 (02) 195-201
    PubMedSearch in Google Scholar
  • 11 Billmire D, Vinocur C, Rescorla F. , et al; Children's Oncology Group. Malignant retroperitoneal and abdominal germ cell tumors: an intergroup study. J Pediatr Surg 2003; 38 (03) 315-318 , discussion 315–318
    CrossrefPubMedSearch in Google Scholar