BACKGROUND Brain tumors are the most common solid tumors in children and comprise 25%of all malignancies in children.Common presentations include headache,nausea and vomiting,gait abnormality,papilledema,and epileptic...BACKGROUND Brain tumors are the most common solid tumors in children and comprise 25%of all malignancies in children.Common presentations include headache,nausea and vomiting,gait abnormality,papilledema,and epileptic seizure;however,some symptoms can be very insidious,with atypical and misleading manifestations.CASE SUMMARY Here,we report a 7-year-old boy who presented with recurrent cyanosis and tachypnea after exercise for 2 years.His body mass index was 26.43 kg/m2.Hepatosplenomegaly,blood gas analysis,biochemical parameters,chest computed tomography scan,and echocardiograph suggested type II respiratory failure,pulmonary heart disease,and mild liver injury.Non-invasive breathing support,antibiotics,and anti-heart failure therapy were given.The patient’s pulse oxygen saturation increased to over 95%when he was awake but dropped to 50%-60%,accompanied by cyanosis,during sleep while receiving high-flow nasal cannula oxygen.Sleep-related breathing disorder was suspected.In the intensive care unit,however,polysomnography was unavailable.Brain magnetic resonance imaging revealed a space-occupying(cerebellum and brainstem)lesion,which was later confirmed to be pleomorphic xanthoastrocytoma by surgery and histopathology by tissue biopsy.CONCLUSION When treating patients with cyanosis and tachypnea,a broad differential diagnosis should be considered,including brain tumor.展开更多
基金Supported by the Science and Technology Department of Sichuan Province,No. 2020YFS0105the West China Second University Hospital of Sichuan University,No. KL036
文摘BACKGROUND Brain tumors are the most common solid tumors in children and comprise 25%of all malignancies in children.Common presentations include headache,nausea and vomiting,gait abnormality,papilledema,and epileptic seizure;however,some symptoms can be very insidious,with atypical and misleading manifestations.CASE SUMMARY Here,we report a 7-year-old boy who presented with recurrent cyanosis and tachypnea after exercise for 2 years.His body mass index was 26.43 kg/m2.Hepatosplenomegaly,blood gas analysis,biochemical parameters,chest computed tomography scan,and echocardiograph suggested type II respiratory failure,pulmonary heart disease,and mild liver injury.Non-invasive breathing support,antibiotics,and anti-heart failure therapy were given.The patient’s pulse oxygen saturation increased to over 95%when he was awake but dropped to 50%-60%,accompanied by cyanosis,during sleep while receiving high-flow nasal cannula oxygen.Sleep-related breathing disorder was suspected.In the intensive care unit,however,polysomnography was unavailable.Brain magnetic resonance imaging revealed a space-occupying(cerebellum and brainstem)lesion,which was later confirmed to be pleomorphic xanthoastrocytoma by surgery and histopathology by tissue biopsy.CONCLUSION When treating patients with cyanosis and tachypnea,a broad differential diagnosis should be considered,including brain tumor.
