Extraneurale Medulloblastommetastase nach nicht operiertem Medulloblastom

Wagner, W.; Hd, Böttcher; Korinthenberg, R; Schadel, A

doi:10.1055/s-2008-1033946

Cited by 6 publications

(3 citation statements)

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“…In our series, no case of extra-axial seeding was seen prior to surgery, and the majority of our patients with extra-axial metastases developed them after primary shunting. These data are in agreement with the literature [31,50] and confirm once again that medulloblastoma, like most other neuroectodermal tumours, tends to remain confined to the neuraxis during the natural course of the disease, and that extra-axial seeding is essentially a iatrogenic phenomenon.…”

Section: Extra-axial Metastasessupporting

confidence: 92%

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Secondary manifestation of medulloblastoma: Metastases and local recurrences in 66 patients

et al. 1995

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Although primary treatment of medulloblastoma is now successful in a high percentage of patients, its secondary manifestations still bear a poor prognosis. Thorough studies of secondary manifestations are therefore pivotal to plan therapeutic approaches for the long-term management of medulloblastoma. Here we describe the incidence of secondary tumour manifestations in 66 patients of a single centre who underwent surgery for medulloblastoma between 1975 and 1990. No patient was excluded due to a poor postoperative course. Thirty-five patients showed evidence of secondary tumour growth. Of these, 17 suffered from local recurrence, and 27 developed metastastatic disease. The median latencies for secondary manifestations were 25 months for local recurrence (n = 17), 11 months for spinal metastases (n = 10), 15 months for supratentorial metastases (n = 8), 8 months for subleptomeningeal dissemination (n = 6), and 23 months for systemic metastases (n = 8). Two patients developed primary metastatic spread to the posterior fossa. Of 8 patients with supratentorial metastases, 6 developed fronto-basal lesions. In our patients, 89% of secondary lesions occurred within less than 3 years after primary diagnosis. 85% of patients with extra-axial tumour spread had been treated with a permanent shunt. Radical tumour resection and radiotherapy with 30 Gy to the neuraxis and 20 Gy boost to the posterior fossa was an important prognostic factor in this series. Patients with additional chemotherapy did not benefit significantly from this treatment. We conclude that optimal management of the primary lesions should aim at (i) total resection, (ii) avoid permanent shunting, and (iii) completion of the radiotherapy with inclusion of the medial frontobasal cisterns in the radiotherapeutic regimen. Our analysis suggests that adequate postoperative screening programmes should consist of 3-monthly scans of the neuraxis in the first three postoperative years and 6-monthly scans thereafter.

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Section: Extra-axial Metastasessupporting

confidence: 92%

“…The authors quote articles from literature (McComb, 1980, Wagner, 1985 confirming the relationship of extra-axial metastases and CSF shunting. It would be necessary to report and discuss also other papers which deny such a relationship (for example: Walker, Rev.…”

Section: Commentmentioning

confidence: 97%

Secondary manifestation of medulloblastoma: Metastases and local recurrences in 66 patients

et al. 1995

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“…Als ausgesprochene Rarität unter den Fernmetastasen gelten solche bei intrakraniellem Primärtu-mor. So sind im internationalen Schrifttum nur ein Fall einer Parotismetastase eines Medulloblastoms [21] und 3 Fälle eines Astrozytoms (Grad III und IV) beschrieben [6,12,14].…”

Section: Diskussionunclassified

Seltene Parotistumoren

Kühn

Köhler

Jecker

2003

HNO

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Tumors of the parotid gland can be benign or malignant lesions.The pathophysiology of rare tumors of the parotid gland is often not sufficiently explored in this paper two rare histological entities are described. In one patient a benign sebaceous lymph-adenoma was histologically diagnosed. This type of tumor accounts for only 0.196 of all adenomas. The international literature is not conclusive about whether the tumor originates in the parotid gland itself or in the parotid lymph nodes. The second patient presented with a metastasis from a glioblastoma in the parotid gland. Again, the mechanism for metastasis of an intra-cerebral tumor to the parotid gland remains unknown. Iatrogenic seeding during a neurosurgical intervention is a probable explanation. The actual clinical course of his patient and the cases described in literature render surgical removal of such a metastasis questionable.

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Metastases from Tumors of the Central Nervous System

2002

TxNxM1

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Extraneurale Medulloblastommetastase nach nicht operiertem Medulloblastom

Cited by 6 publications

References 1 publication

Secondary manifestation of medulloblastoma: Metastases and local recurrences in 66 patients

Secondary manifestation of medulloblastoma: Metastases and local recurrences in 66 patients

Seltene Parotistumoren

Metastases from Tumors of the Central Nervous System

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