Medulloblastoma: Non-Operative Management with Roentgen Therapy After Aspiration Biopsy

Abstract

INTRACRANIAL tumors arising during childhood fortunately are not overly frequent. But, too often, the symptoms and signs are not recognized for weeks to months, with the result that by the time the child is brought for definitive treatment, if he is not virtually moribund, his condition is grave. This is especially true with the medulloblastomas, whose common site of origin is in the cerebellum and roof of the fourth ventricle. Further, their history is commonly that of rapid tumor growth and ultimately marked tendency to disseminate throughout the subarachnoid spaces of the brain and spinal cord. Although of all the gliomas—indeed, of all intracranial primary neoplasms—medulloblastoma appears to be the most vulnerable to irradiation, the roentgen and neurosurgical literature is replete with reports of failures to control this tumor. In the hope that some modification of the management of these cases might effect an improvement in this grim situation, the use of the twist-drill technic developed for ventr...