Abstract
Cerebellar medulloblastoma in adults is an uncommon disease. Therefore, most information comes from the pediatric population, and the treatment for relapses is based on series and case reports. The expression of somatostatin receptors has been identified in most medulloblastoma patients, and preclinical experience has shown a promissory response to somatostatin analogs. This report presents a female patient with a high-risk left cerebellar medulloblastoma diagnosed at age 16 years old who was treated with complete resection, cranial-spinal radiotherapy, and chemotherapy. She presented again at 18 years of age with a sustained progression of her tumor, despite radiosurgery and another line of chemotherapy. Octreotide scintigraphy at that time showed a moderate to high expression of somatostatin receptors; thus, the patient was started on monthly octreotide. She is now 20 and has achieved stable disease over more than two years of active treatment without any drug-related toxicity. Somatostatin analogs could be considered as a treatment option in selected cases of medulloblastoma. Review of the literature is presented for this unusual response.
Highlights
The expression of somatostatin receptors has been identified in most medulloblastoma patients, and preclinical experience has shown a promissory response to somatostatin analogs
This report presents a female patient with a highrisk left cerebellar medulloblastoma diagnosed at age 16 years old who was treated with complete resection, cranial-spinal radiotherapy, and chemotherapy
The standard treatment for adult medulloblastoma patients consists of surgical resection followed by adjuvant radiotherapy and, in some cases, chemotherapy [1]
Summary
The standard treatment for adult medulloblastoma patients consists of surgical resection followed by adjuvant radiotherapy and, in some cases, chemotherapy [1]. There is no standard algorithm for the treatment of patients who relapse or progress after first-line chemotherapy. There is not enough evidence far to support this approach This female patient presented in 2010, at the age of 16 years, with an intense headache, dysarthria, dysmetria, and gait disturbances. Brain imaging done at that time showed a round mass arising from the vermis in the cerebellum, protruding into the fourth ventricle She underwent optimal resection in February 2011, and the pathology specimen confirmed cerebellar medulloblastoma. How to cite this article Galvis L, Gonzalez D, Bonilla C (January 04, 2016) Relapsed High-Risk Medulloblastoma: Stable Disease after Two Years of Treatment with Somatostatin Analog - Case Report. By May 2015, she had undergone 24 months of treatment with a stable lesion on imaging (Figure 4) and clinical improvement, partially recovering independence and functionality, without any drug-related toxicity
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