Multifocal recurrence of medulloblastoma: a long follow-up case study
DOI:
https://doi.org/10.13181/mji.cr.193480Keywords:
intra-axial mass, long follow-up, medulloblastoma, recurrenceAbstract
Medulloblastoma is the most common malignant brain tumor in pediatric patients. Leptomeningeal dissemination often occurs in the spinal canal and rarely into the supratentorial as an extra-axial lesion. This study followed an 8-year progression of multifocal medulloblastoma recurrence as supratentorial metastasis that mimics an intra-axial mass of the temporal lobe. Pathologic examination of the temporal mass showed densely packed small round blue cells that are distributed in a ribboning pattern with areas of necrosis, rosette formation, and mitosis. Ki-67 immunohistochemical staining of the tumor showed a high proliferation index of 40% and revealed positive results for synaptophysin and negative results for glial fibrillary acidic protein and β-catenin. A long follow-up is essential to diagnose the recurrence and elucidate the progression of medulloblastoma.
Downloads
References
Dhall G. Medulloblastoma. J Child Neurol. 2009;24(11):1418-30. https://doi.org/10.1177/0883073809341668
Kumar S, Handa A, Jha DK, Choudhary A. Supratentorial metastasis of medulloblastoma in adults. Asian J Neurosurg. 2016;11(3):320. https://doi.org/10.4103/1793-5482.149993
Lee DS, Cho J, Kim SH, Kim DS, Shim KW, Lyu CJ, et al. Patterns of failure following multimodal treatment for medulloblastoma: long-term follow-up results at a single institution. Cancer Res Treat. 2015;47(4):879-88. https://doi.org/10.4143/crt.2014.067
Smoll NR, Drummond KJ. The incidence of medulloblastomas and primitive neurectodermal tumours in adults and children. J Clin Neurosci. 2012;19(11):1541-4. https://doi.org/10.1016/j.jocn.2012.04.009
Krishna V. Textbook of pathology. 1st ed. Hyderabad: Orient Longman Private Limited; 2004.
O'Brien WT. Imaging of primary posterior fossa brain tumors in children. J Am Osteopath Coll Radiol. 2013;2(3):2-12.
Perreault S, Ramaswamy V, Achrol AS, Chao K, Liu TT, Shih D, et al. MRI surrogates for molecular subgroups of medulloblastoma. Am J Neuroradiol. 2014;35(7):1263-9. https://doi.org/10.3174/ajnr.A3990
Verma A, Kumar I, Verma N, Aggarwal P, Ojha R. Magnetic resonance spectroscopy-revisiting the biochemical and molecular milieu of brain tumors. BBA Clin. 2016;5:170-8. https://doi.org/10.1016/j.bbacli.2016.04.002
Ozerov SS, Tereshchenko GV, Artemov AV, Kumirova EV, Samarin AE, Papusha LI, et al. MRI diagnosis of spinal metastasis of medulloblastoma. A clinical case and literature review. Zh Vopr Neirokhir Im N N Burdenko. 2015;79(5):72-6. https://doi.org/10.17116/neiro201579572-76
Meurer RT, Martins DT, Hilbig A, de Castro Ribeiro M, Roehe AV, Barbosa-Coutinho LM, et al. Immunohistochemical expression of markers Ki-67, neun, synaptophysin, p53 and HER2 in medulloblastoma and its correlation with clinicopathological parameters. Arq Neuropsiquiatr. 2008;66(2B):385 90. https://doi.org/10.1590/S0004-282X2008000300020
Yang Z, Wang KK. Glial fibrillary acidic protein: from intermediate filament assembly and gliosis to neurobiomarker. Trends Neurosci. 2015;38(6):364 74. https://doi.org/10.1016/j.tins.2015.04.003
Shih RY, Koeller KK. Embryonal tumors of the central nervous system: from the radiologic pathology archives. Radiographics. 2018;38(2):525-41. https://doi.org/10.1148/rg.2018170182
Wippold FJ 2nd, Perry A. Neuropathology for the neuroradiologist: rosettes and pseudorosettes. AJNR Am J Neuroradiol. 2006;27(3):488-92.
Ramaswamy V, Remke M, Bouffet E, Faria CC, Perreault S, Cho YJ, et al. Recurrence patterns across medulloblastoma subgroups: an integrated clinical and molecular analysis. Lancet Oncol. 2013;14(12):1200-7. https://doi.org/10.1016/S1470-2045(13)70449-2
Martin AM, Raabe E, Eberhart C, Cohen KJ. Management of pediatric and adult patients with medulloblastoma. Curr Treat Options Oncol. 2014;15(4):581-94. https://doi.org/10.1007/s11864-014-0306-4
Parkes J, Hendricks M, Ssenyonga P, Mugamba J, Molyneux E, Schouten-van Meeteren A, et al. SIOP PODC adapted treatment recommendations for standard-risk medulloblastoma in low and middle income settings. Pediatr Blood Cancer. 2015;62(4):553-64. https://doi.org/10.1002/pbc.25313
Published
How to Cite
Issue
Section
License
Authors who publish with Medical Journal of Indonesia agree to the following terms:
- Authors retain copyright and grant Medical Journal of Indonesia right of first publication with the work simultaneously licensed under a Creative Commons Attribution-NonCommercial License that allows others to remix, adapt, build upon the work non-commercially with an acknowledgment of the work’s authorship and initial publication in Medical Journal of Indonesia.
- Authors are permitted to copy and redistribute the journal's published version of the work non-commercially (e.g., post it to an institutional repository or publish it in a book), with an acknowledgment of its initial publication in Medical Journal of Indonesia.
