Spinal cord astrocytoma presenting as torticollis and scoliosis.

OBJECTIVE

To illustrate the importance of a careful differential diagnosis in children presenting with torticollis.

CLINICAL FEATURES: A 14-yr-old boy presented with a 6-month history of neck pain, torticollis and increasing neurological deficit. Past physiotherapy and chiropractic treatment had not helped. A myelogram and MRI scan revealed a large intramedullary lesion.

INTERVENTION AND OUTCOME: He was treated by laminectomy with partial excision of the lesion, followed by radiotherapy. Pathology confirmed the diagnosis of astrocytoma. The patient developed postlaminectomy instability and required spinal fusion.

CONCLUSION

The differential diagnosis of torticollis in children is extensive and should always include spinal tumor.