Adult Medulloblastoma: Prognostic Factors and Patterns of Relapse

Craniospinal Radiotherapy in Adult Medulloblastoma

“…A noteworthy distinction is the more common late relapse in adults as compared to children, with a median time to recurrence of 26 months and 29% of recurrences occurring > 5 years after treatment [7], whereas pediatric relapses are mostly observed within 2 years [3]. Our median follow-up duration of 46.5 months from the end of radiotherapy -not from the time of diagnosis -seems sufficient.…”

“…Medulloblastoma in adults is highest in the age range 20-34 and tails off by the age range 55-64 [7].…”

“…Patients are currently risk-stratified as average or high risk depending on factors such as age, extent of resection, and presence of metastases. Several series reporting around 30-48 patients [1,7,10,13,17,28,30] and one reporting 156 patients [5] were published in the last 2 decades evaluating adult medulloblastoma. While postoperative craniospinal irradiation is a well-established standard, the value of adjuvant chemotherapy has not been clearly defined in adults in contrast to pediatric patients [34].…”

Neuroradiology and Histopathology in Two Cases of Adult Medulloblastoma

“…In cytogenetic studies, isochromosome 17q or 17p can be found (TP53 location). In addition, molecular overexpression of c-MYC or n-MYC by 5-30% is associated with a worse prognosis 13,14 . The desmoplastic variant is associated with nevoid basocellular carcinoma and has increased fibrous reaction due to leptomeningeal cell proliferation.…”

“…Extension studies must be performed in the management of this high-grade CNS tumour due to its tendency to disseminate to cerebrospinal fluid (CSF) and different meningeal locations. After surgical resection, radiotherapy should also be used to diminish the probability of dissemination 14,15 . Extracranial metastases to bones, lymph nodes, lungs, and liver can be observed in up to 5% of cases of MB, more than any other CNS tumour 2,15 .…”