Medulloblastoma Treatment- Cancer/Oncology, Neurosurgery

Medulloblastoma was originally published by the National Cancer Institute

Medulloblastoma is a primary central nervous system (CNS) tumor. This means it begins in the brain or spinal cord.

What are the grades of medulloblastomas?

Medulloblastomas are all classified as Grade IV tumors. This means they are malignant (cancerous) and fast-growing.

There are four subtypes that have been identified in children with medulloblastoma.

a. WNT-activated

b. SHH-activated

c. Group 3 (non-WNT / non-SHH)

d. Group 4 (non-WNT / non-SHH)

In adults with medulloblastoma, these subtypes are not as well-defined as they are in children.

Who is diagnosed with medulloblastoma?

Medulloblastoma can occur in both children and adults, but is more common in children. In adults, medulloblastoma typically affects younger adults between 20 and 40 years of age. Medulloblastomas are most common in white people.

What causes medulloblastomas?

The cause of most medulloblastomas is not known. There’s a small percent of childhood medulloblastomas that are related to gene changes that can be passed down through families. There’s no known cause for adults diagnosed with medulloblastomas.

Where do medulloblastomas form?

Medulloblastomas most commonly form in the cerebellum, the bottom part of the brain located at the back of the skull. Medulloblastoma is known as an embryonal neuroepithelial tumor because it forms in fetal cells that remain after birth.

Do medulloblastomas spread?

Medulloblastomas are very fast-growing. They often spread to other areas of the CNS through cerebrospinal fluid (CSF). Rarely, medulloblastomas can spread outside the CNS to the bones or the lymphatic system.

What are symptoms of a medulloblastoma?

Symptoms related to a medulloblastoma depend on the tumor’s location. People with a medulloblastoma in the cerebellum may have issues with walking, balance, and/or fine motor skills. If the tumor is blocking the CSF, this can lead to increased pressure inside the skull.  This can cause headaches, nausea, vomiting, blurred and double vision, extreme sleepiness, confusion, seizures and even passing out. If medulloblastoma has spread to the spine, symptoms may include weakness or numbness in the arms and or legs, a change in normal bowel or bladder habits, and spinal pain.

What are treatment options for medulloblastoma?

The first treatment for medulloblastoma is surgery, if possible. The goal of surgery is to obtain tissue to determine the tumor type and to remove as much tumor as possible without causing more symptoms for the person.

Most people with medulloblastomas receive further treatments. Treatments may include radiation, chemotherapy, or taking part in clinical trials.  Surgery is usually followed by radiation to the brain, and even spine since this disease tends to spread in the brain and spine.  Because of problems with bone marrow and surrounding organs that occur with brain and spine radiation, proton beam radiation therapy is often recommended. Chemotherapy may also be part of the treatment plan, depending on the subtype and amount the tumor has spread. Clinical trials, with new chemotherapy, targeted therapy, or immunotherapy drugs, may also be available and can be a possible treatment option. It is important to seek expert recommendations from a neuro-oncologist with experience in adult medulloblastoma. Treatments are decided by the patient’s healthcare team based on the patient’s age, remaining tumor after surgery, tumor type and tumor location.

What does it look like on an MRI?

Medulloblastomas usually appear as a solid mass in the cerebellum, which is the portion of the brain in the back of the head between the cerebrum and the brain stem. The tumor often brightens with contrast. Once the mass is known to be a medulloblastoma, a MRI of the spinal cord is recommended to see if it has spread.

To learn more about Medulloblastoma Treatment, please check our blog on COMMON CHILDHOOD CANCERS.

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