Myelography and cytology in the treatment of medulloblastoma

Abstract

Eight of 22 children with newly diagnosed medulloblastoma had asymptomatic spinal cord involvement detected by myelography. Two additional patients had demonstrable spinal cord lesions at the time of relapse in the posterior fossa. Cerebral spinal fluid (CSF) cytology results were inaccurate in predicting cord involvement. Seven patients have relapsed 9–69 months from completion of radiotherapy. Three had initial cord involvement and also bad subsequent cord involvement at the time of intracranial relapse or afterwards. Frontal lobe involvement as the initial site of relapse occurred-in 3 patients. Computerized tomography has been valuable in the early detection of intracranial relapse. Three children are alive and well 10, 18, and 19 months respectively from time of relapse. All were retreated with radiotherapy in conjunction with misonidazole and subsequent chemotherapy.