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Remote Supratentorial Recurrent Medulloblastoma: Case Study and Literature Review
Asimina Dominari1, Elias Antoniades2, Antonio Capiccelo3
1Aristotle University of Thessaloniki School of Medicine, Thessaloniki, Greece.
Abstract:
Medulloblastomas comprise 10% of pediatric brain tumors. Subfrontal recurrence is uncommon and has been associated with prone positioning, inadequate irradiation of the cribriform plate area, and hydrocephalus management. We discuss the case report of an 8-year-old boy with subfrontal medulloblastoma recurrence. The literature was reviewed using terms such as "medulloblastoma," "subfrontal recurrence," and "child." Forty-eight cases of subfrontal medulloblastoma recurrence were identified. The mean age at presentation was 12.3 years. Gross total resection was achieved in 44%, most patients received adjuvant radiation therapy, and approximately 25% received chemotherapy. The mean recurrence interval was 2.6 years. The mean number of recurrences per patient was 1.2 and the mean survival period was 3.3 years. Even in the case of meticulous resection and sufficient irradiation, recurrences may still occur. Our case indicates that resection of the recurrent lesion and repeat irradiation may benefit patients with satisfactory short-term results.
Insights
Subfrontal recurrence of medulloblastoma in children is rare but can occur despite optimal treatment. This study highlights that repeat surgery and irradiation may offer short-term benefits for recurrent pediatric brain tumors.
Area of Science:
- Pediatric Oncology
- Neuro-oncology
- Radiation Oncology
Background:
- Medulloblastomas represent 10% of pediatric brain tumors.
- Subfrontal recurrence is an uncommon event in pediatric medulloblastoma.
- Risk factors include prone positioning, inadequate cribriform plate irradiation, and hydrocephalus management.
Observation:
- A case of an 8-year-old boy with subfrontal medulloblastoma recurrence is presented.
- A literature review identified 48 cases of subfrontal medulloblastoma recurrence.
- The mean age at recurrence was 12.3 years, with a mean recurrence interval of 2.6 years.
Findings:
- Gross total resection was achieved in 44% of identified cases.
- Adjuvant radiation therapy was common, with chemotherapy used in approximately 25%.
- The mean survival period post-recurrence was 3.3 years.
Implications:
- Recurrence can occur even after meticulous resection and adequate irradiation.
- Resection of recurrent subfrontal medulloblastoma and re-irradiation may provide short-term patient benefit.
- Further research into optimal management strategies for recurrent pediatric brain tumors is warranted.
