Medulloblastoma: Recapitulate divergent tumoral cells dynasties

Alqroom Rami; Malabeh Qamar; Makhamreh Basel; Al Jfout Samer; Alqatamin Hind; Younes Basel; Haddad Feras; Khasawneh Nidal; Al Shurbaji Amer.

Volume : VIII, Issue : II, February - 2019

Medulloblastoma: Recapitulate divergent tumoral cells dynasties

Alqroom Rami, Malabeh Qamar, Makhamreh Basel, Al Jfout Samer, Alqatamin Hind, Younes Basel, Haddad Feras, Khasawneh Nidal, Al Shurbaji Amer.

Abstract :

Introduction: Medulloblastoma is one of the most frequent, violent, invasive, malignant emyonal tumor of the posterior fossa with a partisan demonstration in children. Of 2200 children diagnosed with a ain tumor in the United States, medulloblastoma accounts for 22% of all childhood primary tumors

Objectives: Current study aims to use a retrospectively collected data registry of the surgically treated cases of medulloblastoma to clarify the relative frequencies in our setup over a period of 15–years.

Methods: This retrospective study was conducted under approval by the institutional ethical committee. Institutional patient database of 82–patients who underwent surgical intervention by the Department of Neurosurgery in a single referral center – King Hussein medical center–over a fifteen–year period from January 2002 to January 2017 scrutinized. The clinical diagnosis was confirmed by radiological studies and histopathological reports in all patients. Patients with age ranging from neonate to 18 years were included in the study.

Results: Of the total population consisted of 82–patients, 34 were females and 48 were, 17.1% of medulloblastomas were in children 1–4 years, 39.02% in the 5–9 years, 35.4 % was in 10–14 age group, while 8.53% in older children (14–18 years). Headache and recurrent vomiting were the most common presenting symptoms. Cerebellar ataxic gait was the most common manner of presentation in children younger than 14 years. Drop Mets were present in approximately 29.3% of patients at time of diagnosis. Dilated ventricular system revealed in 57–cases at the time of diagnosis. Symptomatic hydrocephalus was evident in 29–cases as primary presentation, Pre–operative ventriculo–peritoneal shunt inserted in 18–cases, while 22–cases underwent ETV, the reset underwent primary tumor resection. Post tumor resection 16–cases needed shunt procedures. All patients above 4–year old were sent to radiotherapy. Cerebellar mutism syndrome observed in 18– patients. In total, eleven patients underwent a second operation–resection.

Conclusion: Medulloblastoma considered one of the most devastating illnesses, predominantly showing up in children with peak incidence in the first decade, clinical presentation is insidious. Management of medulloblastoma include surgery, adjuvant radiation therapy and/ or chemotherapy. Recent advances in imaging modalities and treatment options and molecular fields, have conveyed about a great improvement in survival in these patients, with recurrence rates relatively low due to a feasible gross total excision and relatively longer survival rate.