A HIGHLY MALIGNANT GASTROESOPHAGEAL REFLUX

Key words: Gastroesophageal reflux, Medulloblastoma, Childhood, Diagnosis

We report a case of a 13-year-old boy with recurrent episodes of vomiting. Initially a diagnosis of gastroesophageal reflux with esophagitis was made. The patient also showed bradycardia and deflections of mood. Neurological assessment and examination of fundus oculi resulted normal. Magnetic resonance imaging of the brain was performed for the persistence of vomiting despite antireflux therapy: cerebellar neoplasm was found. The histological evaluation of the excised neoplasm was consistent with medulloblastoma so the patient was submitted to cancer chemotherapy and he is currently in remission of disease. We present an anecdotal case of delay in the diagnosis of brain tumors in children; in this case the delay was aggravated by the detection of reflux esophagitis and by the normality of neurological assessment and of evaluation of the fundus oculi.