Very Late Frontal Relapse of Medulloblastoma Mimicking a Meningioma in an Adult: Usefulness of 1H Magnetic Resonance Spectroscopy and Diffusion-perfusion Magnetic Resonance Imaging for Preoperative Diagnosis: Case Report

Jouanneau, Emmanuel; Tovar, Rafael Alfonso Guzman; Desuzinges, C.; Frappaz, Didier; Louis-Tisserand, Guy; Sunyach, Marie‐Pierre; Jouvet, Anne; Sindou, Marc

doi:10.1227/01.neu.0000204878.10591.71

Cited by 24 publications

(13 citation statements)

References 30 publications

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“…14 The pattern of behaviour would appear to be the same as for the more frequent paediatric presentation with features of increased intracranial pressure at diagnosis, and as part of the natural history a strong propensity for meningeal spread. 3,15,16 Although there is an association of genetic conditions and medulloblastoma/PNET in the paediatric population, this is not described in adults. 16 There are, however, case reports of this malignancy occurring after previous radiotherapy.…”

Section: Discussionmentioning

confidence: 99%

Medulloblastomas – Primitive neuroectodermal tumours in the adult population

Smee

2008

J Med Imag Rad Onc

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SUMMARYMedulloblastomas -primitive neuroectodermal tumours are rare in adults. This review will evaluate a single centre's experience with this malignancy. The medulloblastoma -primitive neuroectodermal tumour database was evaluated for all patients aged more than 18 years who were referred for management. Relevant information from the database was abstracted to provide a descriptive record of this malignancy. Between 1977-2004 there were 11 patients referred, 1 with persistent disease and 10 were eligible, presenting with initial diagnosis. There was increased intracranial pressure in 50% of patients. Most patients had symptoms .3 months, with three having symptoms 1-3 months before diagnosis and one patient having thoracic dural metastases at presentation. Complete resection was recorded in four patients and six had 50-90% resection. All patients completed craniospinal radiotherapy (35-36 Gy at 1.8-2.0 Gy fractions) barring one patient, who died of surgical complications during his radiotherapy. Chemotherapy was given in five of the nine patients postradiotherapy. There were two posterior fossa recurrences, with associated supratentorial and extra central nervous system disease. Of the 10 primary patients 7 are alive with no evidence of disease, 2 died because of disease, with 1 intercurrent death. One patient developed a second malignancy. The outcome for adults matches that of the more common paediatric patients. Radiotherapy could control local disease even where complete resection was not achieved.

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Section: Discussionmentioning

confidence: 99%

Medulloblastomas – Primitive neuroectodermal tumours in the adult population

Smee

2008

J Med Imag Rad Onc

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“…The first well described case of extra-neural metastasis of medulloblastoma was reported in 1936 19 : since then, few reports have been published in medical literature. The major tendency of medulloblastoma cells to achieve subarachnoid and ventricular spaces predisposes dissemination to the spinal compartment 1,14,19 . Evidence shows that its cells have the ability to survive in subarachnoid environment and have feasibility to dissemination or growth and adhesion to CNS tissue 4 .…”

Section: Case Reportmentioning

confidence: 99%

“…In this particular reported case, the involvement of cranial vascular structures predisposes to the hematogenic dissemination of the neoplasia, especially to thorax. It is known that the most frequent sites implicated in recurrence of the disease is the primary lesion site, followed by metastasis to subfrontal region 3,14 .…”

Section: Case Reportmentioning

confidence: 99%

“…Systemic metastases of medulloblastoma are a rare event, however recurrence in adult population are frequent, especially in primary lesion site 3,14 , both of them with prognostic implications not well defined by far in the literature. As shown, medulloblastoma metastases to the thorax are rare, especially when there is no recurrence in the original site and after a long recureence-free time.…”

Section: Case Reportmentioning

confidence: 99%

“…Its cells ability of surviving in subarachnoid space is well known, what explains, partially, its high recurrence in the CNS. 1,4 There are few reports of extra neural medulloblastoma metastases in literature and it has been associated with lost of meningeal integrity, like the usage of shunts, previous surgical procedures and isolated radiotherapy 2,4,14,18,19 .…”

Section: Introductionmentioning

confidence: 99%

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Thoracic medulloblastoma metastasis

Polverini¹,

Bortoluzzi²,

Filho³

et al. 2018

jbnc

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Introduction: Medulloblastoma is one of the most frequent malignancies of Central Nervous System (CNS) in childhood and has low incidence in adult population. Recurrences are frequent in both populations; systemic metastasis is a rare event. Objective: Report an unusual medulloblastoma case evolution, with thorax metastasis after 6 years of quiescence and compare results with literature data. Methods: Registers survey of previously operated patient from a posterior fossa medulloblastoma with diagnose of thoracic metastasis. Acquired data were analyzed and compared with those from literature. Case report: Twenty-two years-old patient, with a previously operated on posterior fossa medulloblastoma . Six years later, presents with asthenia and vertigo: an x-ray diagnosis of a lesion in the apex of left chest is confirmed with a thoracic computerized tomography. A laparoscopic biopsy is done, disclosing an infiltrative tumor, adherent to the parietal pleura and highly vascularized. AP diagnosis was compatible with metastasis of medulloblastoma. Conclusion: Posterior fossa recurrences are frequent in the adult population, followed by the subfrontal region. About 5% of meduloblastoma metastases are systemic, especially in bones (77%), and even rarer in the lungs, as shown in this report.

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Pediatric Atypical Teratoid/Rhabdoid Tumor: Diagnosis Using Imaging Techniques and Histopathology

Fan

2012

Pediatric Cancer

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Very Late Frontal Relapse of Medulloblastoma Mimicking a Meningioma in an Adult: Usefulness of 1H Magnetic Resonance Spectroscopy and Diffusion-perfusion Magnetic Resonance Imaging for Preoperative Diagnosis: Case Report

Abstract: Late relapse should be considered, even after several decades, on occurrence of a second intracranial tumor in this context. Our observation validates the clinical interest of preoperative metabolic imaging for brain tumors with distinctive pattern.

Cited by 24 publications

References 30 publications

Medulloblastomas – Primitive neuroectodermal tumours in the adult population

Medulloblastomas – Primitive neuroectodermal tumours in the adult population

Thoracic medulloblastoma metastasis

Pediatric Atypical Teratoid/Rhabdoid Tumor: Diagnosis Using Imaging Techniques and Histopathology

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