Surgical Treatment of Intramedullary Spinal Metastasis in Medulloblastoma: Case Report and Review of the Literature

World Neurosurg. 2018 Oct:118:42-46. doi: 10.1016/j.wneu.2018.06.250. Epub 2018 Jul 7.

Abstract

Background: Medulloblastomas are common childhood central nervous system tumors that are prone to leptomeningeal spread. Intramedullary dissemination is rare with very few case reports existing in the available literature.

Case description: The authors here present a case of a 14-year-old boy with Li-Fraumeni syndrome and medulloblastoma who underwent surgical resection of spinal intramedullary spread. Histopathology revealed the tumor to be anaplastic medulloblastoma, same as the intracranial lesions. Genetic testing of the metastatic deposit revealed loss of functions mutations in SUFU, NOTCH3, and TP53 and TERC amplification. An improvement in ambulatory function at short-term follow-up was noted before the patient died of disseminated disease.

Conclusions: Intramedullary metastasis of medulloblastoma remains a rare disease. Surgical resection might play a possible role in management in addition to radiation and chemotherapy.

Keywords: Intramedullary metastasis; Medulloblastoma; Sonic hedgehog; Spinal cord.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Adolescent
  • Cerebellar Neoplasms / diagnostic imaging
  • Cerebellar Neoplasms / surgery*
  • Fatal Outcome
  • Humans
  • Li-Fraumeni Syndrome / diagnostic imaging
  • Li-Fraumeni Syndrome / surgery*
  • Lumbar Vertebrae / diagnostic imaging
  • Lumbar Vertebrae / surgery
  • Male
  • Medulloblastoma / diagnostic imaging
  • Medulloblastoma / surgery*
  • Spinal Cord Neoplasms / diagnostic imaging
  • Spinal Cord Neoplasms / surgery*
  • Thoracic Vertebrae / diagnostic imaging
  • Thoracic Vertebrae / surgery