Multi-nodular Desmoplastic Medulloblastoma in a Child: A Rare Radiological Physiognomy

Songping Zheng, Seidu A. Richard, Yiyun Fu, Yan Ju, Chao You

Abstract


Introduction: Nodular desmoplastic variant of medulloblastoma although very common, can present with very challenging radiological feature that mimics others lesions in the inferior and lower vermis in children. We present a case of rare radiological appearance of desmoplastic medullobastoma. Case Presentation: A one year and nine months old male presented with unstable walking and projectile vomiting of two weeks’ duration. He was apparently walking well prior this illness. The vomiting was usually in the morning and associated with headaches. Radiological imaging revealed very unusual masses in the cerebellum vermin region with obvious bilateral ventricular enlargement as well as the third ventricle, indicating hydrocephalus. Surgery was successful carried out and microscopic as well as immunohistochemistry confirmed desmoplastic medullobastoma. Conclusion: Desmoplastic medulloblastoma although not very rare can be very problematic in terms of radiological diagnosis. We are of the option that our imaging finding will throw more light on the radiological features of this tumor.

Keywords


Multi-nodular, Medulloblastoma, Desmoplastic, Hydrocephalus, Physiognomy

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References


Eran, A., et al., Medulloblastoma: atypical CT and MRI findings in children. Pediatric radiology, 2010. 40(7): p. 1254-1262.

Crawford, J.R., T.J. MacDonald, and R.J. Packer, Medulloblastoma in childhood: new biological advances. The Lancet Neurology, 2007. 6(12): p. 1073-1085.

Roberts, R.O., et al., Medulloblastoma: a population-based study of 532 cases. Journal of Neuropathology & Experimental Neurology, 1991. 50(2): p. 134-144.

DeSouza, R.-M., et al., Pediatric medulloblastoma–update on molecular classification driving targeted therapies. Frontiers in oncology, 2014. 4: p. 176.

Lamont, J.M., et al., Combined histopathological and molecular cytogenetic stratification of medulloblastoma patients. Clinical Cancer Research, 2004. 10(16): p. 5482-5493.

Koral, K., et al., Imaging characteristics of atypical teratoid–rhabdoid tumor in children compared with medulloblastoma. American Journal of Roentgenology, 2008. 190(3): p. 809-814.

Collins, V., Brain tumours: classification and genes. Journal of Neurology, Neurosurgery & Psychiatry, 2004. 75(suppl 2): p. ii2-ii11.

Rieken, S., et al., Outcome and prognostic factors of desmoplastic medulloblastoma treated within a multidisciplinary treatment concept. BMC cancer, 2010. 10(1): p. 450.

Tortori-Donati, P., et al., Medulloblastoma in children: CT and MRI findings. Neuroradiology, 1996. 38(4): p. 352-359.

States, C.B.T.R.o.t.U., Primary Brain Tumors in the United States, Statistical Report, 1997–2001, Years Data Collected. Central Brain Tumor Registry of the United States, Chicago, USA (2004–2005).

Chen, K.-S., et al., Medulloblastoma or cerebellar dysplastic gangliocytoma (Lhermitte-Duclos disease)? Pediatric neurology, 2002. 27(5): p. 404-406.

Giangaspero, F., et al., Medulloblastoma with extensive nodularity: a variant with favorable prognosis. Journal of neurosurgery, 1999. 91(6): p. 971-977.

Halperin, E.C., D.M. Watson, and S.L. George, Duration of symptoms prior to diagnosis is related inversely to presenting disease stage in children with medulloblastoma. Cancer, 2001. 91(8): p. 1444-1450.

Nelson, M., C. Diebler, and W.S.C. Forbes, Paediatric medulloblastoma: atypical CT features at presentation in the SIOP II trial. Neuroradiology, 1991. 33(2): p. 140-142.

Koeller, K.K. and E.J. Rushing, From the Archives of the AFIP: Medulloblastoma: A Comprehensive Review with Radiologic-Pathologic Correlation 1. Radiographics, 2003. 23(6): p. 1613-1637.

Rumboldt, Z., et al., Apparent diffusion coefficients for differentiation of cerebellar tumors in children. American Journal of Neuroradiology, 2006. 27(6): p. 1362-1369.

Moreno-Torres, Á., et al., Taurine detection by proton magnetic resonance spectroscopy in medulloblastoma: contribution to noninvasive differential diagnosis with cerebellar astrocytoma. Neurosurgery, 2004. 55(4): p. 824-829.

Smits, M., et al., Incorporating functional MR imaging into diffusion tensor tractography in the preoperative assessment of the corticospinal tract in patients with brain tumors. American Journal of Neuroradiology, 2007. 28(7): p. 1354-1361.

Robertson, P.L., et al., Incidence and severity of postoperative cerebellar mutism syndrome in children with medulloblastoma: a prospective study by the Children’s Oncology Group. Journal of Neurosurgery: Pediatrics, 2006. 105(6): p. 444-451.

Paterson, E. and R. Farr, Cerebellar medulloblastoma: treatment by irradiation of the whole central nervous system. Acta radiologica, 1953. 39(4): p. 323-336.

Oyharcabal-Bourden, V., et al., Standard-risk medulloblastoma treated by adjuvant chemotherapy followed by reduced-dose craniospinal radiation therapy: a French Society of Pediatric Oncology Study. Journal of clinical oncology, 2005. 23(21): p. 4726-4734.

Gottardo, N.G. and A. Gajjar, Current therapy for medulloblastoma. Current treatment options in neurology, 2006. 8(4): p. 319-334.

Grill, J., et al., Treatment of medulloblastoma with postoperative chemotherapy alone: an SFOP prospective trial in young children. The lancet oncology, 2005. 6(8): p. 573-580.

Taylor, R.E., et al., Outcome for patients with metastatic (M2–3) medulloblastoma treated with SIOP/UKCCSG PNET-3 chemotherapy. European journal of cancer, 2005. 41(5): p. 727-734.

Packer, R.J., et al., Phase III study of craniospinal radiation therapy followed by adjuvant chemotherapy for newly diagnosed average-risk medulloblastoma. Journal of Clinical Oncology, 2006. 24(25): p. 4202-4208.

Katsetos, C.D., et al., Cerebellar desmoplastic medulloblastomas. A further immunohistochemical characterization of the reticulin-free pale islands. Archives of pathology & laboratory medicine, 1989. 113(9): p. 1019-1029.

Giangaspero, F., et al., “Desmoplastic” versus “classic” medulloblastoma: comparison of DNA content, histopathology and differentiation. Virchows Archiv, 1991. 418(3): p. 207-214.




DOI: https://doi.org/10.7575/aiac.abcmed.v.7n.1p.49

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