Solitary cerebellar tumefactive demyelination in a child: A radiological and histological conundrum

Abstract

Abstract Pediatric tumefactive demyelination (TD) is a very rare pathology. There are no previous case reports of histopathologically proven solitary cerebellar TD in children. We report the case of a 7-year-old girl who presented with headache, vomiting, and imbalance. Magnetic resonance imaging (MRI) of the brain showed an irregular enhancing lesion in the left cerebellar paravermian region with perilesional edema. On a preoperative diagnosis of high-grade tumor, she underwent complete excision with an intraoperative frozen section suggestive of a glial neoplasm. Histopathology revealed a diagnosis of TD. Solitary TDs of the cerebellum in children are extremely rare. This is the first report of a histologically proven isolated cerebellar TD in a child. We discuss the diagnostic difficulty and surgical dilemma in the management of this case.