Intractable Localized Pruritus as the Sole Manifestation of Intramedullary Tumor in a Child

Abstract

We recommend a detailed neurologic examination in any case of persistent localized pruritus, in the absence of primary dermatologic causes. Given the challenges of performing a reliable neurologic examination in children, neuroimaging might be considered in children with intractable localized pruritus of unknown etiology of the head and neck or upper extremity, even in the absence of focal neurologic deficits.

Brachioradial pruritus in a patient with metastatic breast cancer to her cervical spine

“…Localized cutaneous pruritus may be related to damage of the peripheral nerve, nerve root, spinal cord, or central nervous system. 5 Our patient's dermatomal distribution of symptoms correlated well with the locations of her spinal metastases, supporting this theoretical mechanism.…”

“…2 Although most BRP is seen in the setting of cervical spine degenerative changes, a few cases have been reported secondary to primary spinal cord tumors. [4][5][6][7][8] To our knowledge, this is the first case of BRP reported in the setting of metastatic malignancy to the cervical spine.…”

Pruritus as a complication of foramen magnum neurinoma

“…Facial pruritus resolved soon after tumor removal; the tumor was diagnosed as a neurinoma. Therefore, as previously reported, localized pruritus can be caused by spinal or medullary tumors.…”

Periumbilical neuropathic pruritus in an infant: presentation of a spinal intramedullary neoplasm

“…3 Intramedullary neoplasms presenting with localized pruritus are rare but have been reported in the adult 4 and paediatric population. 5,6 In children, astrocytoma is the most common intramedullary neoplasm causing pruritus followed by glioma. 5 Treatment of intramedullary neoplasms is complex.…”

“…5,6 In children, astrocytoma is the most common intramedullary neoplasm causing pruritus followed by glioma. 5 Treatment of intramedullary neoplasms is complex. Surgical removal of the lesion may resolve the symptoms; however most lesions are inoperable due to the localization.…”