FOXR2-Mediated CNS Neuroblastoma in a Pediatric Patient Treated With Multimodal Therapy Including Proton Craniospinal Irradiation: A Case Report.
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FOXR2-activated central nervous system (CNS) neuroblastoma is a rare embryonal tumor characterized by an aggressive nature, frequent leptomeningeal dissemination, and poor prognosis without intensive multimodal therapy. We report a four-year-old girl with multifocal FOXR2-altered CNS neuroblastoma treated with subtotal resection, multi-agent chemotherapy per ACNS0334, autologous stem cell transplant, and proton craniospinal irradiation (CSI) with focal boost. This case highlights modern management strategies and the rationale for proton therapy in reducing long-term treatment toxicity in very young children.