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

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