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Aqamour R, Leknani M, Nasri S, Kamaoui I, Skiker I. Peritoneal metastasis of a cerebellar medulloblastoma through a ventriculoperitoneal shunt: A case report. Radiol Case Rep 2024; 19:3610-3612. [PMID: 38983304 PMCID: PMC11228656 DOI: 10.1016/j.radcr.2024.05.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2024] [Revised: 05/02/2024] [Accepted: 05/06/2024] [Indexed: 07/11/2024] Open
Abstract
Medulloblastoma is a frequent and aggressive pediatric tumor. It causes intracranial hypertension, necessitating ventriculoperitoneal shunting with surgical resection. Intraperitoneal metastases are rare and result from the migration of neoplastic cells through the shunt and into the peritoneal cavity. This metastatic form involving the ventriculoperitoneal shunt has a poor prognosis, making therapeutic management even more difficult. We report the case of a 14-year-old boy with a history of medulloblastoma of the cerebellum who was initially treated with complete resection of the tumor with placement of a ventriculoperitoneal shunt, followed by radiotherapy and chemotherapy, with good progression until he presented to the emergency department with acute abdominal symptoms. Imaging revealed multiple peritoneal masses with intra- and retroperitoneal lymphadenopathies. An ultrasound-guided biopsy revealed a metastatic medulloblastoma in the peritoneal cavity, and the patient underwent chemotherapy. The placement of the ventriculoperitoneal shunt in the tumor dissemination is therefore to blame.
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Affiliation(s)
- Ranya Aqamour
- Faculty of Medicine and Pharmacy, Mohammed Ist University, Oujda, Morocco
- Department of Radiology, Mohammed VI University Hospital Mohammed I University, Oujda, Morocco
| | - Mohammed Leknani
- Department of Radiology, Mohammed VI University Hospital Mohammed I University, Oujda, Morocco
| | - Siham Nasri
- Faculty of Medicine and Pharmacy, Mohammed Ist University, Oujda, Morocco
- Department of Radiology, Mohammed VI University Hospital Mohammed I University, Oujda, Morocco
| | - Imane Kamaoui
- Faculty of Medicine and Pharmacy, Mohammed Ist University, Oujda, Morocco
- Department of Radiology, Mohammed VI University Hospital Mohammed I University, Oujda, Morocco
| | - Imane Skiker
- Faculty of Medicine and Pharmacy, Mohammed Ist University, Oujda, Morocco
- Department of Radiology, Mohammed VI University Hospital Mohammed I University, Oujda, Morocco
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Thanh Dung L, Minh Duc N. Medulloblastoma in the cerebellopontine angle mimicking a schwannoma. Clin Case Rep 2021; 9:1948-1953. [PMID: 33936621 PMCID: PMC8077292 DOI: 10.1002/ccr3.3912] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Accepted: 01/23/2021] [Indexed: 02/05/2023] Open
Abstract
The typical distinction between cerebellopontine angle (CPA) medulloblastoma and other primary CPA tumors was not fully known. While CPA medulloblastoma is very uncommon, it should be included in the differential diagnosis of patients with CPA tumors.
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Affiliation(s)
- Le Thanh Dung
- Department of RadiologyViet Duc HospitalHa NoiVietnam
- Department of RadiologyHanoi Medical UniversityHa NoiVietnam
| | - Nguyen Minh Duc
- Department of RadiologyHanoi Medical UniversityHa NoiVietnam
- Department of RadiologyPham Ngoc Thach University of MedicineHo Chi Minh CityVietnam
- Department of RadiologyChildren's Hospital 2Ho Chi Minh CityVietnam
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3
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Vigneron C, Antoni D, Coca A, Entz-Werlé N, Lutz P, Spiegel A, Jannier S, Niederst C, Jarnet D, Meyer P, Kehrli P, Noël G. [Pediatric medulloblastoma: Retrospective series of 52 patients]. Cancer Radiother 2016; 20:104-8. [PMID: 26996790 DOI: 10.1016/j.canrad.2015.11.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2015] [Revised: 11/22/2015] [Accepted: 11/25/2015] [Indexed: 10/22/2022]
Abstract
PURPOSE Retrospective analysis of the results of 52 children irradiated for a medulloblastoma. PATIENTS AND METHODS Between 1974 and 2012, 52 children with an average age of 6 years and a half (11 months-17 years and a half) were treated with surgery then with radiotherapy at the Comprehensive Cancer Centre of Strasbourg (France). For 44 children, the treatment consisted of a chemotherapy. RESULTS After a mean follow-up of 106.6 months (7-446 months), 13 relapses and 24 deaths were observed. Overall survival at 5 years and 10 years were 62% and 57%, respectively. Disease-free survival at 5 years and 10 years were 80% and 63%, respectively. Univariate analysis found the following adverse prognostic factors: the existence of a postoperative residue, the positivity of the cerebrospinal fluid, the metastatic status and medulloblastoma of high-risk. Positivity of the cerebrospinal fluid remains a negative factor in multivariate analysis. CONCLUSION These results confirm the survival rate obtained by a conventional approach (surgery then irradiation). Insufficiency of results and rarity of medulloblastoma require the establishment of international protocols.
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Affiliation(s)
- C Vigneron
- Département de radiothérapie, CLCC Paul-Strauss, 3, rue de la Porte-de-l'Hôpital, 67065 Strasbourg, France
| | - D Antoni
- Département de radiothérapie, CLCC Paul-Strauss, 3, rue de la Porte-de-l'Hôpital, 67065 Strasbourg, France
| | - A Coca
- Service de neurochirurgie, CHU Hautepierre, 67000 Strasbourg, France
| | - N Entz-Werlé
- Service d'oncologie pédiatrique, CHU Hautepierre, 67000 Strasbourg, France
| | - P Lutz
- Service d'oncologie pédiatrique, CHU Hautepierre, 67000 Strasbourg, France
| | - A Spiegel
- Service d'oncologie pédiatrique, CHU Hautepierre, 67000 Strasbourg, France
| | - S Jannier
- Service d'oncologie pédiatrique, CHU Hautepierre, 67000 Strasbourg, France
| | - C Niederst
- Département de radiothérapie, CLCC Paul-Strauss, 3, rue de la Porte-de-l'Hôpital, 67065 Strasbourg, France
| | - D Jarnet
- Département de radiothérapie, CLCC Paul-Strauss, 3, rue de la Porte-de-l'Hôpital, 67065 Strasbourg, France
| | - P Meyer
- Département de radiothérapie, CLCC Paul-Strauss, 3, rue de la Porte-de-l'Hôpital, 67065 Strasbourg, France
| | - P Kehrli
- Service de neurochirurgie, CHU Hautepierre, 67000 Strasbourg, France
| | - G Noël
- Département de radiothérapie, CLCC Paul-Strauss, 3, rue de la Porte-de-l'Hôpital, 67065 Strasbourg, France; Laboratoire EA 3430, fédération de médecine translationnelle de Strasbourg (FMTS), université de Strasbourg, 67000 Strasbourg, France.
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Vigneron C, Antoni D, Coca A, Niederst C, Jarnet D, Meyer P, Kehrli P, Noël G. Médulloblastomes de l’adulte : étude rétrospective portant sur 21 patients. Cancer Radiother 2016; 20:14-7. [DOI: 10.1016/j.canrad.2015.07.156] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2015] [Revised: 07/06/2015] [Accepted: 07/22/2015] [Indexed: 10/22/2022]
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Pant I, Chaturvedi S, Gautam VKS, Pandey P, Kumari R. Extra-axial medulloblastoma in the cerebellopontine angle: Report of a rare entity with review of literature. J Pediatr Neurosci 2016; 11:331-334. [PMID: 28217158 PMCID: PMC5314849 DOI: 10.4103/1817-1745.199477] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
With only 33 cases reported so far, a purely extra-axial position of medulloblastoma at cerebellopontine (CP) angle is quite exceptional. We report a case of extra-axial medulloblastoma in a 15-year-old male child located in the CP angle that was surgically treated with a provisional diagnosis of schwannoma. Histopathological diagnosis of medulloblastoma was made with the routine hematoxylin and eosin stain and immunohistochemical markers. This case report highlights the fact that although extremely rare, the possibility of an extra-axial mass being a medulloblastoma does exist.
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Affiliation(s)
- Ishita Pant
- Department of Pathology, Institute of Human Behaviour and Allied Sciences, New Delhi, India
| | - Sujata Chaturvedi
- Department of Pathology, Institute of Human Behaviour and Allied Sciences, New Delhi, India
| | - Vinod K S Gautam
- Department of Neurosurgery, Institute of Human Behaviour and Allied Sciences, New Delhi, India
| | - Pranjal Pandey
- Department of Neurosurgery, Institute of Human Behaviour and Allied Sciences, New Delhi, India
| | - Rima Kumari
- Department of Neuroradiology, Institute of Human Behaviour and Allied Sciences, New Delhi, India
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Vigneron C, Entz-Werlé N, Lutz P, Spiegel A, Jannier S, Helfre S, Alapetite C, Coca A, Kehrli P, Noël G. [Evolution of the management of pediatric and adult medulloblastoma]. Cancer Radiother 2015; 19:347-57; quiz 358-9, 362. [PMID: 26141663 DOI: 10.1016/j.canrad.2015.03.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2014] [Revised: 01/05/2015] [Accepted: 03/02/2015] [Indexed: 10/23/2022]
Abstract
Medulloblastoma are cerebellar tumours belonging to the group of primitive neuroectodermal tumours (PNET) and are the most common malignant brain tumours of childhood. These tumours are rare and heterogeneous, requiring some multicentric prospective studies and multidisciplinary care. The classical therapeutic approaches are based on clinical, radiological and surgical data. They involve surgery, radiation therapy and chemotherapy. Some histological features were added to characterize risk. More recently, molecular knowledge has allowed to devise risk-adapted strategies and helped to define groups with good outcome and reduce long-term sequelae, improve the prognostic of high-risk medulloblastoma and develop new therapeutic tools.
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Affiliation(s)
- C Vigneron
- Département de radiothérapie, centre de lutte contre le cancer Paul-Strauss, 3, rue de la Porte-de-l'Hôpital, BP 42, 67065 Strasbourg cedex, France
| | - N Entz-Werlé
- Service d'oncologie pédiatrique, CHU Hautepierre, 1, avenue Molière, 67098 Strasbourg cedex, France
| | - P Lutz
- Service d'oncologie pédiatrique, CHU Hautepierre, 1, avenue Molière, 67098 Strasbourg cedex, France
| | - A Spiegel
- Service d'oncologie pédiatrique, CHU Hautepierre, 1, avenue Molière, 67098 Strasbourg cedex, France
| | - S Jannier
- Service d'oncologie pédiatrique, CHU Hautepierre, 1, avenue Molière, 67098 Strasbourg cedex, France
| | - S Helfre
- Département de radiothérapie, institut Curie, 26, rue d'Ulm, 75005 Paris, France
| | - C Alapetite
- Département de radiothérapie, institut Curie, 26, rue d'Ulm, 75005 Paris, France
| | - A Coca
- Service de neurochirurgie, CHU Hautepierre, 1, avenue Molière, 67098 Strasbourg cedex, France
| | - P Kehrli
- Service de neurochirurgie, CHU Hautepierre, 1, avenue Molière, 67098 Strasbourg cedex, France
| | - G Noël
- Département de radiothérapie, centre de lutte contre le cancer Paul-Strauss, 3, rue de la Porte-de-l'Hôpital, BP 42, 67065 Strasbourg cedex, France; Laboratoire EA 3430, fédération de médecine translationnelle de Strasbourg (FMTS), université de Strasbourg, 4, rue Kirschleger, 67085 Strasbourg cedex, France.
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Rico-Varela J, Singh T, McCutcheon S, Vazquez M. EGF as a New Therapeutic Target for Medulloblastoma Metastasis. Cell Mol Bioeng 2015; 8:553-565. [PMID: 26594253 DOI: 10.1007/s12195-015-0395-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
Medulloblastoma (MB) is a malignant pediatric brain tumor known for its aggressive metastatic potential. Despite the well-documented migration of MB cells to other parts of the brain and spinal column, MB chemotaxis is poorly understood. Herein, we examined the in vitro migratory and cellular responses of MB-derived cells to external signaling of Epidermal Growth Factor (EGF), hepatocyte growth factor (HGF), platelet-derived growth factor (PDGF-BB), and the stromal cell-derived factors 1-alpha (SDF-1). Experiments utilized transwell assays and immunocytochemistry to identify receptor activation in MB migration, and used a microfluidic platform to examine directionality, trajectory, and gradient-dependence of motile cells. Data illustrates that MB-derived cells respond strongly to EGF in a dosage and gradient-dependent manner with increased EGF-R activation, and show that high EGF gradient fields cause an increased number of cells to migrate longer directed distances. Our results provide evidence that EGF and its receptor play an important role than previously documented in MB chemotactic migration than previously documented and should be considered for developing migration-target therapies against MB metastasis.
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Affiliation(s)
- Jennifer Rico-Varela
- Department of Biomedical Engineering, The City College of New York, 160 Convent Avenue, ST-403D, New York, NY 10031
| | - Tanya Singh
- Department of Biomedical Engineering, The City College of New York, 160 Convent Avenue, ST-403D, New York, NY 10031
| | - Sean McCutcheon
- Department of Biomedical Engineering, The City College of New York, 160 Convent Avenue, ST-403D, New York, NY 10031
| | - Maribel Vazquez
- Department of Biomedical Engineering, The City College of New York, 160 Convent Avenue, ST-403D, New York, NY 10031
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Meshkini A, Vahedi A, Meshkini M, Alikhah H, Naghavi-Behzad M. Atypical medulloblastoma: A case series. Asian J Neurosurg 2014; 9:45-7. [PMID: 24891891 PMCID: PMC4038867 DOI: 10.4103/1793-5482.131077] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Medulloblastoma is common in children as a tumor of midline posterior fossa, which arises from vermis and appears as a homogenously enhancing hyperdense mass on computed tomography scan and is associated with the clinical picture of posterior fossa syndrome. This unique clinic-radiological pattern in considered “typical” medulloblastoma, but medulloblastomas does not follow the typical clinic-radiological pattern in a significant number of children and adult cases. We review here the previous reports of atypical or uncommon features of medulloblastoma and add our very rare atypical cases of medulloblastomas to this list. Medulloblastoma should be considered in all midline posterior fossa tumors, hemisphere and cerebellopontine angle despite having clinical and radiological features suggestive of other tumors. Definitive diagnosis requires histologic confirmation in all cases.
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Affiliation(s)
- Ali Meshkini
- Neuroscience Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Amir Vahedi
- Department of Pathology, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mohammad Meshkini
- Students' Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Hossein Alikhah
- Medical Philosophy and History Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mohammad Naghavi-Behzad
- Students' Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran ; Medical Philosophy and History Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
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A contemporary review of molecular candidates for the development and treatment of childhood medulloblastoma. Childs Nerv Syst 2013; 29:381-8. [PMID: 23292496 DOI: 10.1007/s00381-012-2014-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2012] [Accepted: 12/22/2012] [Indexed: 12/23/2022]
Abstract
INTRODUCTION Medulloblastoma is the most common pediatric central nervous system tumor; however, the causes are not well established. There has been some emphasis on mutations in developmental pathways and their impact on tumor pathology in hereditary diseases, but, in order to better understand the nature of diseases like medulloblastoma, other mechanisms also require attention. PURPOSE The purpose of this review is to provide an overview of the main genes involved in neurodevelopment, their downstream targets, and modulatory links by growth factors. Occurrence of pediatric brain tumors including medulloblastoma are mostly sporadic, but some hereditary diseases like Li-Fraumeni syndrome, Gorlin's syndrome, Turcot's syndrome, and Rubenstein-Tarbi syndrome are known to contribute their development as consequences of germline mutations at specific points: DNA-repairing gene Tp53 for Li-Fraumeni syndrome or Patch for Gorlin's, and apoptosis-related gene product adenomatous polyposis coli for Turcot's disease. CONCLUSION Intracellular relations at molecular level and future therapeutics that specifically target the corresponding pathways should be well understood in order to prevent and cure childhood medulloblastoma.
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Abstract
INTRODUCTION The term of "medulloblastoma" refers to cerebellar tumors belonging to the family of primitive neuro-ectodermic tumors (PNET). Medulloblastomas represent 40% of cerebellar tumors, 15 to 20% of brain tumors and the first cause of malignant brain tumors in childhood. Seventy to 80% of cases are diagnosed in children versus 20 to 30% in adults. UPDATED KNOWLEDGE Diagnosis is based on clinical and radiological exams, and proved on pathological analysis in association with molecular biology. Treatment comprises surgery, craniospinal radiotherapy except for children under five years of age and chemotherapy according to age and high-risk criteria. Medulloblastoma is a rare case of a central nervous system tumor which is radio- and chemo-sensitive. Treatment goals are, on one hand, to improve the survival rates and, on the other hand, to avoid late neurocognitive, neuroendocrine and orthopedic side effects related to radiation therapy, notably in children. The prognosis is relatively good, with a five year survival rate over 75% after complete resection of a localized tumor although sequelae may still compromise outcome. PERSPECTIVES AND CONCLUSION Management of patients with medulloblastoma implies a multidisciplinary approach combining the contributions of neurosurgery, neuroradiology, pediatric oncology, neuro-oncology and radiotherapy teams.
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Cognitive consequences of the treatment of medulloblastoma among children. Pediatr Neurol 2011; 44:21-30. [PMID: 21147383 DOI: 10.1016/j.pediatrneurol.2010.07.004] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2008] [Revised: 01/14/2009] [Accepted: 07/06/2010] [Indexed: 11/22/2022]
Abstract
Progress in the treatment of medulloblastoma has resulted in increased survival among children. However, effective treatment, especially radiation therapy, produces negative consequences in the cognitive development of children, in terms of decreased intelligence quotients. Determining the factors underlying this decrease may influence the types of rehabilitation needed by children who undergo treatment for medulloblastoma. We review recent research on the impact of some factors that may underlie the cognitive deficits of pediatric and adolescent survivors, i.e., verbal comprehension, perceptual organization, attention, and processing speed. We assess eight pediatric survivors of medulloblastoma treatment with surgery, radiation, and chemotherapy. Children were assessed twice after diagnosis, using the Wechsler Intelligence Scale for Children-Third Edition. A large decrease in cognitive capacity was evident, as measured by intelligence quotients and factor indices. A raw score analysis of 12 subtests was performed, indicating a slower acquisition of functions and knowledge in the domains of verbal comprehension, perceptual organization, social perception, and psychomotor skills. We discuss issues of social reintegration, and propose that the rehabilitation of pediatric patients must include a program for social reinsertion, in addition to psychoeducational support.
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