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June 1993

Pathological Cases of the Month

Am J Dis Child. 1993;147(6):691-692. doi:10.1001/archpedi.1993.02160300097034

A 2-year-old girl was brought to her pediatrician because of a rapidly growing lump in the left suboccipital area that had doubled in size in the previous 6 weeks. Pregnancy, delivery, growth, and development were normal. Physical examination revealed a normally developed girl with a large left suboccipital mass measuring 4.6 cm in diameter. The mass was nonpulsatile and slightly tender. Results of the rest of the physical exami

Figure 1.

Figure 3. nation were normal. Computed tomography of the head revealed a left suboccipital irregular defect extending throughout the thickness of the bone into the posterior fossa (Fig 1). The defect contained a 4×2-cm soft-tissue mass that enhanced uniformly after administration of an intravenous contrast substance. The inner margin of the mass was immediately adjacent to the left cerebellar hemisphere, which was slightly indented by the mass. The brain parenchyma was normal. Complete blood cell count, prothrombin time, and