Approach to a suspected brain tumor (pediatrics) Quiz: Ace Your Exams
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A previously healthy 2-year-old boy is brought to the clinic by a parent for a one-month history of early morning headaches and a wide-based, unsteady gait. These symptoms are not associated with fever or seizures. Family, birth, and developmental histories are non-contributory. Temperature is 37°C (98.6°F), pulse is 100/min, respirations are 24/min, blood pressure is 96/52 mmHg, and oxygen saturation is 99% on room air. On physical examination, the child is alert and active. Neurological exam reveals ataxia, and fundoscopic exam shows bilateral papilledema. Strength, tone, and reflexes are normal. Magnetic resonance imaging (MRI) of the brain reveals a large mass in the posterior fossa. Gross total resection is performed, and pathology shows Homer Wright rosettes and small, round blue cells with foci of necrosis. Which of the following is the most likely diagnosis?
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