Childhood Medulloblastoma Revisited.

Area of Science:

• Pediatric Oncology
• Neuro-oncology
• Molecular Pathology

Background:

• Medulloblastoma is the most frequent malignant pediatric central nervous system tumor.
• Recognized morphological variants include classic, large cell/anaplastic, desmoplastic/nodular, and medulloblastoma with extensive nodularity.
• Recent molecular profiling has led to a genetically defined classification.

Purpose of the Study:

• To review recent advances in medulloblastoma understanding.
• To correlate basic science and clinical findings with diagnostic imaging.
• To discuss implications for current neuroimaging practices.

Main Methods:

• Review of transcriptome and methylome profiling studies.
• Analysis of the 2016 World Health Organization Classification of Tumors of the Central Nervous System.
• Integration of molecular subgroups with clinical and imaging data.

Main Results:

• Medulloblastoma classification now includes WNT-activated, SHH-activated, Group 3, and Group 4 genetically defined groups.
• This classification forms the basis for risk stratification in clinical trials.
• Subgroups within the major groups reveal further molecular heterogeneity.

Conclusions:

• Molecular classification significantly impacts medulloblastoma diagnosis and treatment.
• Understanding molecular subgroups is crucial for personalized medicine approaches.
• Neuroimaging plays a vital role in correlating molecular characteristics with tumor presentation and behavior.