Diagnosing Teen's Brain Tumor with Precise Technology

Matthew Ukachukwu

When 16-year-old Matthew Ukachukwu arrived at our emergency department, he was experiencing headaches, vomiting and sleepiness. Already diagnosed at his community hospital with a brain tumor, our physicians found that he was suffering from hydrocephalus--an accumulation of cerebrospinal fluid due to obstruction caused by his tumor.

Matthew was admitted to the intensive care unit where Ann Marie Flannery, MD, chief of pediatric neurosurgery at the Medical Center, ordered various diagnostic and laboratory studies. Based on the results of those tests and given his age and sex, Dr. Flannery felt fairly certain that the tumor was an intracranial germinoma, which occurs with much greater frequency in males.

"Knowing that this was probably a germinoma helped guide my decision making," said Dr. Flannery. "And the University of Chicago Medical Center has all of the resources necessary readily available to handle this situation."

Dr. Flannery drilled a very small hole in the boy's skull, through which she placed an endoscope, or a lighted tube. Using computer-assisted surgical navigation, she was able to create a new pathway, called a third ventriculocysternotomy, for the fluid to travel around the obstruction. She also was able to obtain a sample of the tumor to confirm her diagnosis.

Ann Marie Flannery, MD

"The ability to make a diagnosis and relieve the hydrocephalus, which is life-threatening, with a minimally invasive procedure is due to the availability of relatively new technology," Dr. Flannery said. Without such technology and expertise, obtaining a diagnosis would have meant he would have been required to endure an open craniotomy in which a large section of the skull is removed and the brain must be incised in order to access the tumor.

Armed with the diagnosis and having stabilized Matthew, Dr. Flannery referred him to Charles Rubin, MD, associate professor of pediatrics at the Medical Center and an authority on childhood cancers. Now under Dr. Rubin's care, Matthew is receiving chemotherapy and low-dose radiation therapy as a participant in a national clinical trial comparing that regimen with the standard treatment, which is higher-dose radiation therapy.

"Radiation can have serious side effects on the brain, including compromising cognitive development and interfering with other learning processes," said Dr. Rubin. "As a study participant, it is predicted that Matthew will have the same chance for a good outcome but hopefully be spared some of these undesirable consequences."