Medulloblastoma
Medulloblastoma are tumours of the cerebellum that most frequently arise in infancy and childhood. They are embryonic tumours with an infiltrative growth into sourrounding tissue.
Histology of Medulloblastoma
- fast and infiltrative growth (WHO grade IV)
- desmoplastic/nodular medulloblastoma
- anaplastic medulloblastoma
- medulloblastoma with extensive nodularity
- large cell medulloblastoma
Epidemiology of Medulloblastoma
- represent 20% of all brain tumours in children and adolescents and 1% in adults
- children usually have a classical medulloblastoma
- in adults frequently desmoplastic medulloblastoma
Symptoms of Medulloblastoma
- short anamnesis (weeks up to a few months)
- headache and gait disturbance
- vomiting
- double vision
Diagnosing Medulloblastoma
- CT or MRI with contrast agent
- heterogeneous enhancement of contrast agent
- clearly defined lesion
- frequently small edema
- often hemorrhages and necrosis
- possibly examination of liquor and MRI of spinal cord
- typically in posterior fossa (4th ventricle)
Therapy of Medulloblastoma
- if possible complete surgical removal
- frequently sensitive to chemotherapy
- chemotherapy (e.g. MTX, CCNZ and cisplatin)
- radiotherapy
Therapy of Recurrent Medulloblastoma
- if possible (re-)operation
- possibly second radiotherapy
- chemotherapy (preferably another drug than in first therapy)
Aftercare of Medulloblastoma
- MRI/CT first every 3 months
- every 6 months if findings are unsuspicuous
Course of Medulloblastoma
- even after 10 years recurrences have been seen
- often metastasise in spinal cord, but rarely at first diagnosis
- in course distant metastases possible
Prognosia of Medulloblastoma
- depending on size of tumour, extent of surgery and possible metastatic spread
- desmoplastic medulloblastoma have a slightly better prognosis
