Medulloblastoma

• Medulloblastoma:

  • Most common malignant tumour in children
  • Thought to arise from cerebella stem cells between the brainstem and cerebellum near the fourth ventricle
  • Medulloblastomas tend to be within CSF pathways giving rise to its high metastatic propensity
• Clinical features include:

  • Hydrocephalus: worsening headaches and decreased level of consciousness
  • Cerebellar signs: incoordination of limbs, gait abnormalities
  • Mass effect symptoms: speech and vision abnormalities, unilateral weakness, headache, drowsiness and nausea/vomiting
  • Extraocular muscle palsies: typically presents as diplopia
• Relevant investigations include:

  • Lumbar puncture (LP): performed post-operatively and useful for staging
  • MRI +/- CT including spinal imaging
• Management options for medulloblastoma include:

  • Surgical removal of the tumour
  • Radiotherapy
  • Chemotherapy
• Prognosis:

  • The five-year survival for standard-risk patients is approximately 70%.