Objective To analyze the clinical manifestations,treatment and prognosis of adult medulloblastoma (MB).Methods A total of 163 cases of adult MB,confirmed by surgical and pathological diagnosis,were retrospectively analyzed about the clinical manifestations,imaging,treatment and prognosis.There are 108 males and 55 females in the group,whose average age was 28.6-year-old.Results The main clinical manifestations include headache,nausea,vomiting,dizziness,gait disturbance,hypopsia,diplopia,hearing loss and cerebellum crisis.Gross total resection was achieved in 90 cases,subtotal resection in 67 cases and biopsy in 6 cases.Survival time from surgery to progression or death or the last date of follow-up were measured and estimated by the Kaplan-Meier method.Among a total of 160 follow-up patients with MB,postoperative overall survival time was from 7 to 170 months,median survival time was (127±6) months (95％ CI 115.3-138.68).The 5-year overall survival time of adult MB patients was 73.1％ (120/163).The log-rank test was used to compare the significance of the following prognostic variables.Among all clinical factors,patients undergoing the craniospinal irradiation had a significantly better survival rate than those without this treatment (44 months vs 34 months,x2 =8.712,P =0.003).Conclusion Good therapeutic effect of MB be achieved by adopting surgical resection with early enough craniospinal irradiation.Recurrence and metastasis are the two main factors for bad prognosis in adult MB.

OBJECTIVETo study the pathologic characteristics and prognosis in different subtypes of adult medulloblastoma (MB).

METHODSThe clinical information, imaging findings and pathologic characteristics of 151 cases of adult medulloblastomas were retrospectively reviewed and analyzed by chi-square test. The survival data were assessed using the Kaplan-Meier method.

RESULTSAmongst the 151 MB cases studied, there were 73 cases of classic MB, 36 cases of desmoplastic/nodular MB, 39 cases of anaplastic MB and 3 cases of large cell MB. The primary tumors were more frequently located in cerebral hemisphere in desmoplastic/nodular MB than in other subtypes (P=0.000).On the other hand, large cell/anaplastic MB were associated with more frequently local recurrence and distant metastasis (P=0.003). The post-operative overall survival time ranged from 6 to 150 months, with median survival being (103.3±5.7) months (95%CI, 92.52 to 115.09). The median survival of classic MB, desmoplastic/nodular MB and large cell/anaplastic MB was (110.7±7.8) months, (125.5±7.6) months and (57.6±7.6) months, respectively. The differences were statistically significant (P=0.000).

CONCLUSIONSThe three variants of MB show different biologic behavior. Large cell/anaplastic MB represents an independent poor prognostic indicator in adults.

Adolescent ; Adult ; Cerebellar Neoplasms ; classification ; metabolism ; pathology ; radiotherapy ; surgery ; Disease-Free Survival ; Female ; Follow-Up Studies ; Glial Fibrillary Acidic Protein ; metabolism ; Humans ; Kaplan-Meier Estimate ; Ki-67 Antigen ; metabolism ; Male ; Medulloblastoma ; classification ; metabolism ; pathology ; radiotherapy ; surgery ; Middle Aged ; Neoplasm Recurrence, Local ; Phosphopyruvate Hydratase ; metabolism ; Radiotherapy, Adjuvant ; Retrospective Studies ; Survival Analysis ; Synaptophysin ; metabolism ; Young Adult