The medulloblastoma is a tumor of the cerebellum, particulary common in children. Most of them in childhood are situated in the midline vermis, but in adults are in the lateral lobes. The authors reported two cases of medulloblastoma which developed in the midline vermis although the patients were adult, and reviewed with concerned articles.
Adult* ; Cerebellum ; Child ; Humans ; Medulloblastoma*

A case of cerebral glioma which was developed 5 years after brain irradiation for medulloblastoma is reported. The etiology and pathogenesis of human glioma are still unknown. The possible causal role of radiation therapy in inducing cerebral glioma is discussed on the basis of these observations.
Brain ; Child* ; Glioma* ; Humans ; Medulloblastoma

Atypical teratoid/rhabdoid tumor rarely occurs in the CNS, though is most common in infants under two years of age. It is characterized by unique histologic features, has an extremely aggressive natural course, and is located mainly in the infratentorial region. Radiologically, it is difficult to distinguish from primitive neuroectodermal tumor or medulloblastoma. We report the radiologic findings of two cases of atypical teratoid/rhabdoid tumor.
Humans ; Infant ; Medulloblastoma ; Neuroectodermal Tumors, Primitive

Intracranial tumor with extracranial metastasis has been seldom reported. A 28 year-old-male was admitted to Presbyterian Hospital in Daegu on May 9, 1977. Who was diagnosed to have a medulloblastoma in the right cerebellar hemisphere with metastases to the right axillary lymphnode and head of pancreas by pathological reports. In generally medulloblastoma with extracranial metastasis occurs very rarely in the cerebellar hemisphere, and especially in adulthood. Distant metastasis of the intracranial tumor is discussed with review of the literatures.
Daegu ; Head ; Medulloblastoma* ; Neoplasm Metastasis ; Pancreas ; Protestantism

Cerebellar Neoplasms ; ultrastructure ; Humans ; Medulloblastoma ; ultrastructure

The majority of deaths due to intracranial tumors are preceded by long periods of symptoms, resulting in diagnosis of the tumors. And introduction of CT and MRI have led to increased early detection of intracranial tumors. Nonetheless, sudden unexpected deaths from intracranial tumors are rarely encountered at autopsy. We report an autopsy case of 2-year-old boy who died from medulloblastoma.
Autopsy ; Brain Neoplasms ; Death, Sudden ; Medulloblastoma ; Preschool Child

PURPOSE: Firstly, to analyze factors in terms of radiation treatment that might potentially cause subfrontal relapse in two patients who had been treated by craniospinal irradiation (CSI) for medulloblastoma. Secondly, to explore an effective salvage treatment for these relapses. MATERIALS AND METHODS: Two patients who had high-risk disease (T3bM1, T3bM3) were treated with combined chemoradiotherapy. CT-simulation based radiation-treatment planning (RTP) was performed. One patient who experienced relapse at 16 months after CSI was treated with salvage surgery followed by a 30.6 Gy IMRT (intensity modulated radiotherapy). The other patient whose tumor relapsed at 12 months after CSI was treated by surgery alone for the recurrence. To investigate factors that might potentially cause subfrontal relapse, we evaluated thoroughly the charts and treatment planning process including portal films, and tried to find out a method to give help for placing blocks appropriately between subfrotal-cribrifrom plate region and both eyes. To salvage subfrontal relapse in a patient, re-irradiation was planned after subtotal tumor removal. We have decided to treat this patient with IMRT because of the proximity of critical normal tissues and large burden of re-irradiation. With seven beam directions, the prescribed mean dose to PTV was 30.6 Gy (1.8 Gy fraction) and the doses to the optic nerves and eyes were limited to 25 Gy and 10 Gy, respectively. RESULTS: Review of radiotherapy portals clearly indicated that the subfrontal-cribriform plate region was excluded from the therapy beam by eye blocks in both cases, resulting in cold spot within the target volume. When the whole brain was rendered in 3-D after organ drawing in each slice, it was easier to judge appropriateness of the blocks in port film. IMRT planning showed excellent dose distributions (Mean doses to PTV, right and left optic nerves, right and left eyes: 31.1 Gy, 14.7 Gy, 13.9 Gy, 6.9 Gy, and 5.5 Gy, respectively. Maximum dose to PTV: 36 Gy). The patient who received IMRT is still alive with no evidence of recurrence and any neurologic complications for 1 year. CONCLUSION: To prevent recurrence of medulloblastoma in subfrontal-cribriform plate region, we need to pay close attention to the placement of eye blocks during the treatment. Once subfrontal recurrence has happened, IMRT may be a good choice for re-irradiation as a salvage treatment to maximize the differences of dose distributions between the normal tissues and target volume.
Brain ; Chemoradiotherapy ; Craniospinal Irradiation ; Humans ; Medulloblastoma* ; Optic Nerve ; Radiotherapy ; Recurrence*

The case is reported of a 2 1/2-year-old femal with headache, vomiting and paraparesis. Clinical feature and operative findings are quite different from those of classic medulloblastoma in its lateral location, well-circumscribed tendency, non-invasiveness, no CSF metastasis, and favourable prognosis after surgical removal. Histological features are the combination of those of classic, and desmoplastic medulloblastoma. Review of literature was done.
Child* ; Headache ; Humans ; Medulloblastoma* ; Neoplasm Metastasis ; Paraparesis ; Prognosis ; Vomiting

Some individuals may demonstrate a secondary phase nystagmus (SPN) following the caloric irrigation. It has been stated that if a SPN begins prior to 140 seconds after the onset of caloric stimulation and if the magnitude of the slow phase velocity is greater than 6 degrees/sec, then a premature reversal caloric nystagmus (PRCN) is said to exit. Thus far, there have been no reports describing PRCN in Korea. We described a typical PRCN in a patient with medulloblastoma within the 4th ventricle. The patient had a gaze-evoked horizontal and upbeating nystagmus. However, there was no indication of spontaneous nystagmus. A monothermal caloric test was administered. The initial left beating primary phase nystagmus was subsided at 60 seconds after right cold water stimulation and at 110 seconds, a right beating SPN with 14 degrees/sec of slow phase velocity was appeared and was continuous for 240 seconds. Although the precise mechanism of PRCN is unknown, vestibular nuclei damage may be related.
Caloric Tests ; Humans ; Korea ; Medulloblastoma ; Nystagmus, Physiologic* ; Vestibular Nuclei ; Water

Authors analyzed the results of treatment in 49 cases of medulloblastoma who had been operated upon at the Seoul National University Hospital from January 1972 to June 1987. There were 2 cases(4%) of postoperative mortality(death within postoperative one month) and 13 cases of late moratlity. The 3-year overall survival rate was 49.3% and 3-year disease-free survival rate was 48.5%. The risk period of recurrence was about 2 years after surgery. The 3-year survival rate was significantly better in "grow total resection" group, "radiation dose more than 50 Gy" group, and group II(23 cases operated after July 1982) (p<0.05). The rate of posterior fossa recurrence was lower in "gross total resection" group for the patients who received posterior fossa irradiation of more than 50 Gy.
Disease-Free Survival ; Humans ; Medulloblastoma ; Prognosis* ; Recurrence ; Seoul ; Survival Rate