Clinical Analysis of Posterior Fossa Medulloblastoma in Children.

Park, Cheol Wan; Kim, Kwang Myung; Oh, Suck Jun; Kim, Nam Kyu; Chung, Hwan Yung; Lee, Hahng; Lee, Seung Ro; Lee, Myung Za

Original Article

Journal of Korean Neurosurgical Society 1990;19(4): 549-558.

Cheol Wan Park, Kwang Myung Kim, Suck Jun Oh, Nam Kyu Kim, Hwan Yung Chung, Hahng Lee, Seung Ro Lee, Myung Za Lee

¹Department of Neurosurgery, School Medicine, Hanyang University, Seoul, Korea.
²Department of Pediatrics, School Medicine, Hanyang University, Seoul, Korea.
³Department of Radiology, School Medicine, Hanyang University, Seoul, Korea.

ABSTRACT

The author analyzed 15 children with medulloblastoma confirmed histopathologically at the Department of Neurosurgery of the Hanyang University Hospital from Jan. 1981 to Jan. 1989. The results were as followings : 1) The mean age of incidence was 9.3 years and male to female ratio was 2 : 1. 2) The most common symptoms were those of increased intracranial pressure noted in all cases(100.0%), cerebellar symptoms and signs in 7 cases(46.7%) and the brain stem symptoms and signs in 2 cases(13.3%). The symptom duration varied from 7 to 180 days with a mean of 60 days. 3) In the majority of patients(12 cases, 80.0%), tumor was located in the midline on the computed tomographic scanning of the brain and as less typical features of the medulloblastoma, calcification and cystic or necrotic zone within the tumor mass occurred in 5 cases(33.3%) and in 6 cases(40.0%) respectively, suggesting higher frequency than observed in other articles. 4) The tumors with calcification within tumor mass were larger in size and presented with longer symptom duration than those without calcification. And tumors with cystic or necrotic zone within tumor mass were larger in size and presented with shorter symptom duration than those without such lesions. 5) Among 8 cases managed with various degree of surgical resections and full doses of postoperative radiotherapy, spinal metastasis occurred in 1 case(12.5%) at 26 months after the operation. 6) In conclusion, aggressive therapeutic approach with combined modalities, utilizing radical resection of the tumor, scheduled postoperative radiotherapy and chemotherapy, seemed to exert beneficial influence on the outcome, with no evidence of disease in 4 out of 6 cases during the follow up period of 8 to 27 months.

Key Words: Medulloblastoma; Radical resection; Radiotherapy; Chemotherapy; Spinal metastasis