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Phys Sportsmed. 2009 Apr;37(1):133-7. doi: 10.3810/psm.2009.04.1694.

Case report: a case of persistent back pain and constipation in a 5-year-old boy.

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Children's Hospital Boston, Havard Medical School, Boston, MA 02115, USA.


Pediatric intramedullary spinal cord tumors are rare and account for 3% to 6% of all central nervous system tumors. Astrocytomas are infiltrating neoplasms, and they predominate in the pediatric population. We report a case of an intramedullary spinal cord astrocytoma in a 5-year-old boy with nonspecific mid-back pain for 3 months. Physical examination revealed clonus, thoracolumbar tenderness, and pain with sitting straight leg raises. An urgent magnetic resonance imaging showed an intramedullary tumor in the mid-thoracic cord, confirmed by surgical excision. The physician should maintain a high index of suspicion when evaluating the pediatric patient who presents with unexplained and persistent back pain. Associated findings, including nocturnal pain and neurological symptoms may indicate a more serious underlying pathology such as a tumor. Early detection, prompt treatment, and proper post surgical management will often lead to improved outcomes in patients.

[Indexed for MEDLINE]

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