Case:

Previously healthy 3-year-old right handed boy presented after a generalized tonic clonic seizure at night. Neurological exam was benign. EEG showed some transient left temporal slowing and central spikes while drowsy and asleep. MRI showed 5.5 x 5.2 x 5.1 cm mass in the white matter of left frontal lobe that crossed midline with 9 mm shift and no evidence of metastasis to spine. CT brain done at the time of birth due to neonatal sepsis was completely normal denoting rapid growth within 3 years. Patient underwent craniotomy with complete excision of the tumor. Histopathology showed abundant neuropil and focal ependymoblastic rosettes. It was positive for LIN28. Molecular analysis showed amplification of the miRNA locus on chromosome 19 (C19MC). Patient received intensive induction chemotherapy followed by autologous PBSC (peripheral blood smear cells) and GCSF (granulocyte cell stimulating factor). Subsequent MRI brain at 3, 6 and 12 months showed no recurrence of tumor and patient is doing well with no neurological deficits.