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Study Title: Hiccup as a Main Symptom of Medulloblastoma in a Fossa Cranii Posterior in a 15-Year-Old Boy
Authors: Manoleva Nikolovska E, Bogoeva Kostovska K, Emel Markovska D
Institution: PHI Polyclinic MANOLEVI
Background
Medulloblastoma is one of the most common malignant CNS tumors in children.
Typically arises in the cerebellum or posterior fossa.
Common symptoms:
Headache
Vomiting
Clumsiness or ataxia
General malaise
Feeding difficulties
Often mimics benign childhood conditions, making early diagnosis challenging.
Objective
Present an atypical symptom presentation of medulloblastoma: prolonged hiccups in a 15-year-old boy.
Highlight importance of considering CNS causes when general symptoms persist.
Methods / Case Presentation
Patient: 15-year-old boy
Symptom timeline:
5 months before diagnosis: morning-only hiccups
3 months: constant hiccups throughout the day
1 month: morning vomiting began
No headache, malaise, or visual problems
Gastrointestinal evaluation ruled out GI causes
Routine fundus examination revealed abnormal findings → CNS tumor suspected
MRI confirmed a posterior fossa mass
Surgical excision performed
Histopathology confirmed medulloblastoma
Results
Persistent hiccups were the main presenting symptom.
No typical cerebellar or systemic signs were initially present.
GI investigations were normal, highlighting the atypical nature of the symptom.
Conclusion
Prolonged hiccups, though usually linked to GI conditions, can rarely indicate CNS pathology such as medulloblastoma.
Persistent general symptoms in children warrant thorough investigation beyond common causes.
Early recognition of atypical presentations can lead to timely diagnosis and treatment of serious conditions.
If you want, I can also make a very short “clinical alert note” for pediatricians emphasizing hiccups as a red-flag for CNS pathology. This can be useful for practice.
Do you want me to do that?
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