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Spinal cord tumour — RACP Paediatrics MCQ

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HardNeurologySpinal cord tumourRACP Paediatrics

A 10-year-old presents with 4 weeks of progressive back pain worse at night, unilateral leg weakness, and new-onset scoliosis. Neurological examination shows upper motor neuron signs in the left leg with a sensory level. MRI shows an intradural extramedullary mass compressing the spinal cord. What is the most likely diagnosis?

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Correct answer: B — Spinal cord tumour

Progressive back pain (worse at night, not relieved by rest), neurological deficit, and scoliosis with an intradural mass on MRI suggests a spinal cord tumour. Common types in children include astrocytoma (intramedullary) and ependymoma. An intradural extramedullary mass could be a nerve sheath tumour or meningioma. Urgent neurosurgical referral is essential.

Reference: RCH Melbourne – 2023 – Back Pain CPG; RACP Paediatric Curriculum – Neurology/Oncology