Extraaxial Cerebellopontine Angle Medulloblastoma with Multiple Intracranial Metastases in Adult: A Rare Case Report with a Review of Literature

Posterior fossa giant adenoid cystic carcinoma with skull base invasion mimicking glomus jugulare: A case report and review of literature

The author describes a rare case of giant adenoid cystic carcinoma (ACC) mimicking large paraganglioma with lower cranial nerve palsy. A 60-year-old female presented with a progressive increase in postauricular swelling with unilateral hearing loss, facial deviation, difficulty in swallowing, and hoarseness of voice. MRI brain showed highly vascular infiltrating and osteolytic mass suggestive of large glomus jugulare versus sarcoma. It was completely engulfing the jugular foramen and lower cranial nerves with bony erosion of the jugular foramen and occipital condyle. The whole mastoid was filled with the tumor. On digital subtraction angiography the majority of blood supply was from the occipital branch of the external carotid artery and vertebral artery. The patient underwent percutaneous embolization followed by external carotid ligation and resection of the mass. The postoperative course was uneventful. Histopathology was suggestive of mixed ACCs. The patient received radiotherapy. After 1 year of follow up no recurrence or distant metastasis was noted.

Medulloblastoma at the cerebello-pontine angle resembling vestibular schwannoma: A case report and review of the literature

Cerebello-pontine angle (CPA) tumors account for only less than 10 % of intracranial tumors, it usually affects children at a young age with the midline being the most favorable location. Our adult patient demonstrated a very unusual site for medulloblastoma at the CPA. Less than 50 cases all around the world have been reported in the English literature for Medulloblastoma to be located at the CPA, and most of them in pediatric age group.

We report a 43 year old female patient who presented to our neurosurgical ward in Jerusalem with a 4 months history of progressive decreased hearing at the left side, accompanied with tinnitus, dizziness, and imbalance on walking. Medulloblastoma at the CPA was one of the differential diagnosis and was confirmed at our histopathology unit after gross total resection of the tumor, the surgery followed by radiotherapy and the patient was well after 9 months after procedure.

MB-CPA is a relatively rare tumor, and the early diagnosis make a difference in the management, prognosis, and outcomes, so it should be considered as a differential diagnosis of a lesion of the CPA.

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Medulloblastoma at the Cerebello-Pontine Angle (CPA MB) is a rare aggressive tumor that can mostly occur in children and extremely rare in adults.

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Aggressive surgical resection is the first line in management.

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Post-operative radiation therapy and/or chemotherapy play a role in reducing recurrence.

Extra-axial Desmoplastic Medulloblastoma in Adult Cerebellopontine Angle: Case Report and Noninvasive Molecular Subgrouping Utilizing Magnetic Resonance Imaging-Based Radiomics Nomogram

Cerebellopontine angle (CPA) is an atypical site for adult medulloblastoma (MB) with only 12 cases reported in pure extra-axial location. None was predicted on preoperative imaging while the most common misdiagnosis was petrous meningioma. We add the 13^th case to this list, attempting to reiterate the radiological features for preoperative prediction of this rare pathology on conventional magnetic resonance imaging (MRI). Molecular subtyping also is not yet reported for adult extra-axial CPA MB. We propose the routine use of MRI-based nomograms, in atypical CPA extra-axial masses, for noninvasive prediction of molecular subgroup, especially in resource-limited setups that lack the facility of genetic profiling.

Extra-axial tentorial medulloblastoma: a rare presentation of a common posterior fossa tumour

Medulloblastoma is a common paediatric posterior fossa tumour typically presenting as midline intra-axial mass involving the cerebellar vermis and/or roof of fourth ventricle with typical radiological features. These can be extra-axial in extremely rare instances with less than 50 cases reported so far in literature. We present a case of 18-year-old boy presenting with ataxia and headache. MRI showed dural mass (involving the left tentorium cerebellum) with typical imaging features of extra-axial lesion. The patient underwent near total excision of the tumour. Histopathology along with immunohistochemistry revealed the mass to be medulloblastoma. We present this case to highlight rarity of this location for medulloblastoma and the importance of considering this in the differential diagnosis of atypical posterior fossa extra-axial lesions. This can help in performing other relevant preoperative workup similar on the lines of medulloblastoma and planning of relevant management.