Metastatic brainstem medulloblastoma: a clinical case report

Abstract

Medulloblastoma (MB) is one of the most common tumors of the central nervous system (CNS) of embryonic origin. MB is a malignancy that is quite common in pediatric patients; it represents a small proportion of brain tumors in young people, with an incidence of 0.6 per million per year. The peak age of diagnosis among the pediatric population is 3-6 years, while patients between 15 and 44 years old account for only 25%. The purpose of the study: to demonstrate a clinical case of surgical treatment of a patient with CNS metastasis of brainstem medulloblastoma. Methods. The article presents our clinical case of surgical treatment of a patient with medulloblastoma metastasis to the right temporal lobe. Results. Medulloblastoma is a heterogeneous brain tumor that is very rare in adults, especially those over 40 years of age, and accounts for less than 1% of all primary brain tumors in adults. Medulloblastoma metastases are most often found in the spinal cord and its membranes, less often in the cerebral hemispheres and ventricular system, which is associated with cerebrospinal fluid pathways. In foreign and Russian literature, there are relatively few publications on studies of metastatic lesions of medulloblastoma in adults; these studies are either considered as separate clinical observations or in conjunction with the development of medulloblastoma metastases in children. Non-specific neurological symptoms of medulloblastoma in adults can lead to later instrumental studies and specific therapy, and can also act as an unfavorable prognostic factor for the disease. Conclusion. Early detection and neurosurgical intervention are the key to preventing mortality and improving patient outcomes. Currently, only a few cases of medulloblastoma in adults are known; to prevent patient mortality, more detailed genetic and molecular studies of MB, including cerebrospinal fluid, risk stratification, description of oncological treatment, and monitoring of results to analyze MB sensitivity to chemotherapy and EBRT, as well as maintaining a registry of patients over 18 years old with brain medulloblastoma and dynamic observation of their family members in connection with oncological vigilance are needed.