MRI of medulloblastoma in adults

Abstract

Medulloblastoma has variable appearances on MRI in both children and adults. Adults are more likely to have heterogeneous cerebellar hemisphere tumours, and this is thought to be related to the greater prevalence of desmoplastic tumours in adulthood. Few studies have addressed the MRI features of adult medulloblastoma and the specific characteristics of desmoplastic and classic tumours have not been analysed. Our aim was to analyse the imaging characteristics of desmoplastic (DM) and classic (CM) medulloblastomas in adult. We retrospectively studied preoperative MRI of six men and three women, median age 33 years, range 23-53 years, with pathologically proved medulloblastomas. There were six (67%) with DM. The tumour was in the cerebellar hemisphere in eight patients (89%), including the three with CM, one of which was bilateral. All tumours were heterogeneous, giving predominantly low or isointense signal on T1- and isointense signal on T2-weighted images. Cystic or necrotic areas in all patients were particularly visible on T2-weighted images. Contrast enhancement was absent in one DM and varied from slight to intense in eight (three CM), homogeneous in one DM and patchy in seven. All tumours extended to the surface of the cerebellum and two had well-defined margins. MRI does not allow a clear distinction between DM and CM in adults.

Boost Gamma Knife surgery during multimodality management of adult medulloblastoma

“…3,9 Finally, although MR imaging remains the imaging workhorse for declaring residual versus recurrent disease, it is recognized that medulloblastoma, particularly in adults, has a variable appearance on MR images, exhibiting the wide range of potential enhancement from none to intensely homogeneous. 9 Recognizing the current dependence on enhancement to distinguish brain tumor from normal brain tissue, we hope that the application of new imaging modalities such as proton MR spectroscopy, diffusion weighted imaging, and 111 In octreotide scintigraphy will refine our identification of residual and recurrent medulloblastoma. …”

Desmoplastic Medulloblastoma in a 48-Year-Old Male

“…Adults are more likely to have heterogeneous cerebellar hemisphere tumors, and this is thought to be related to the greater prevalence of desmoplastic tumors in adulthood (Malheiros et al 2003). Koci et al (1993) reviewed preoperative MRI of 12 patients aged 18-53 years, seen over a period of 9 years.…”

“…Medulloblastoma is rare in adults and is more frequently in the cerebellar hemisphere and more often DM than in children ( Carrie et al 1994;Malheiros et al 2003). The adult presentation of medulloblastoma is an infrequent disease entity that shows both similarities and discrepancies with its pediatric counterpart.…”

“…This type of tumor rarely occurs beyond the fifth decade of life (Giangaspero et al 2000;Malheiros et al 2003). We present a case of desmoplastic medulloblastoma in a 48-year-old male.…”

Medulloblastoma of the Cerebellopontine Angle in a Child: A Rare Entity

“…In rare cases they present with ill-defined margins, hypointensity signal on T2, mild or nodular enhancement. [4][5][6] Cerebellopontine angle (CPA) is an uncommon site and only 39 cases have been reported to date in best of our knowledge. We report a further case of CPA MB in a 12 year old female child.…”