J Manipulative Physiol Ther. 1994 Feb; 17(2): 113-8.

Spinal cord astrocytoma presenting as torticollis and scoliosis.

Bussieres A, Cassidy JD, Dzus A.

Canadian Memorial Chiropractic College, Toronto, Ontario.

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.