medulloblastoma_case_reports

Medulloblastoma case reports

Hadzipasic M, Karsten MB, Olson H, Rodan L, Lidov H, Prabhu SP, Wright K, Fehnel KP. Medulloblastoma in the setting of megalocephaly polymicrogyria polydactyly hydrocephalus. Am J Med Genet A. 2021 Feb 25. doi: 10.1002/ajmg.a.62125. Epub ahead of print. PMID: 33634562.


A 36-year-old diagnosed with pulmonary sarcoidosis presented with ataxia, bilateral horizontal nystagmus, diplopia, and bilateral upper limb dysmetria was found to have a cerebellar mass on magnetic resonance imaging (MRI). He was initially treated with corticosteroids as a case of neurosarcoidosis. The patient's symptoms worsened, and repeat MRI showed an increase in the tumor's size with hydrocephalus. External ventricular drain (EVD) insertion plus midline suboccipital craniotomy and resection of the tumor was performed. Pathology revealed MB classic type, sonic hedgehog (SHH)-activated. There was no CSF dissemination. He received craniospinal radiation and chemotherapy. Follow up 20 months after radiation revealed residual neurological symptoms and no recurrence on MRI brain.

The exceedingly rare coexistence of adult medulloblastoma and sarcoidosis may have a causal relationship based on specific common molecules. Leukotrienes, stimulation of astrocytes and Purkinje neurons, and the SHH signaling pathway can be considered. Further genetic and molecular studies are merited 1).


A 63-year-old woman with an atypical medulloblastoma in the cerebellum and a lesion in the suprasellar area that did not appear to be a metastasis of the medulloblastoma. The patient underwent a subtotal resection of the cerebellar medulloblastoma which was classified histologically as classic subtype and molecularly as non-WNT/non-Sonic hedgehog (SHH) subtype in the World Health Organization Classification of Tumors of the Central Nervous System 2016. Then she underwent postoperative chemotherapy followed by radiotherapy. We administered chemotherapy to facilitate therapeutic diagnosis of the suprasellar lesion. The combination treatment resulted in the disappearance of the cerebellar medulloblastoma with treatment toxicity well tolerated, additionally the suprasellar lesion remains under control.

Even in adults over 60 years of age, medulloblastoma should be included in the differential diagnosis of a cerebellar mass, and chemotherapy for adult medulloblastoma has the potential to be efficacious and tolerable 2).


1)
Elarjani T, Altewerki M, Alsuwaidan A, Alhuthayl M, Hassounah M. Molecular Association of Medulloblastoma and Sarcoidosis: Case Report and Review of the Literature. World Neurosurg. 2020 Sep 30:S1878-8750(20)32154-9. doi: 10.1016/j.wneu.2020.09.135. Epub ahead of print. PMID: 33010513.
2)
Murase M, Saito K, Abiko T, Yoshida K, Tomita H. Medulloblastoma in Older Adults: A Case Report and Literature Review. World Neurosurg. 2018 Jun 5. pii: S1878-8750(18)31170-7. doi: 10.1016/j.wneu.2018.05.216. [Epub ahead of print] PubMed PMID: 29883827.
  • medulloblastoma_case_reports.txt
  • Last modified: 2021/02/26 19:04
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