Abstract
Medulloblastoma (MB) is a malignant brain tumor with a usual potential for leptomeningeal spread. Intramedullary metastases of MB are rare and there are very few cases reported in the literature. Here, we report the case of an 18-year-old man with intramedullary spinal cord metastasis of MB occurring 9 years after the first diagnosis. The patient presented a 2-month history of progressive weakness in both lower limbs associated with urinary incontinence. Magnetic resonance imaging (MRI) demonstrated a large intramedullary spinal cord tumor extending from T10 to L1. The patient underwent surgical decompression and adjuvant therapy. Histological examination confirmed the diagnosis of classic MB metastasis. Postoperatively, the neurological status was stationary. Intramedullary metastasis of medulloblastoma is rare and difficult to manage with a poor prognosis. Comprehensive studies on the medulloblastoma dissemination mechanisms and clinical trials are needed to assess combined therapeutic approaches on metastases of MB.
Highlights
Medulloblastoma (MB) is the most common malignant tumor of childhood and constitutes approximately 30% of pediatric brain tumors [1]
Intramedullary metastasis of medulloblastoma is rare and difficult to manage with a poor prognosis
We reported a case of intramedullary spinal cord metastasis of MB which occurred 9 years after first management of the vermian medulloblastoma without a local recurrence
Summary
Medulloblastoma (MB) is the most common malignant tumor of childhood and constitutes approximately 30% of pediatric brain tumors [1]. Adjuvant treatment is often considered to avoid the dissemination of a local tumor and to control the disease. Intramedullary spinal cord metastasis is rare and to date, there are few cases reported in the literature [2] [3] [4] [5] [6]. We reported a case of intramedullary spinal cord metastasis of MB which occurred 9 years after first management of the vermian medulloblastoma without a local recurrence. This case report aims to discuss the pathogenesis of ISCM in MB and the role of surgery for managing medulloblastoma recurrence according to the literature
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