An adult multifocal medulloblastoma with diffuse acute postoperative cerebellar swelling: immunohistochemical and molecular genetics analysis

• Published in: Neurosurgical review Vol. 38; no. 1; pp. 1 - 10
• Main Authors: Balik, Vladimir, Trojanec, Radek, Holzerova, Milena, Tuckova, Lucie, Sulla, Igor, Megova, Magdalena, Vaverka, Miroslav, Hrabalek, Lumir, Ehrmann, Jiri
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01-01-2015
• Subjects: Adult; Brain Edema - complications; Brain Edema - diagnosis; Brain Edema - surgery; Cerebellar Neoplasms - diagnosis; Cerebellar Neoplasms - pathology; Cerebellar Neoplasms - surgery; Female; Humans; Immunohistochemistry - methods; Medicine; Medicine & Public Health; Medulloblastoma - complications; Medulloblastoma - diagnosis; Medulloblastoma - genetics; Medulloblastoma - surgery; Neurosurgery; Pathology, Molecular; Postoperative Period; Review; Multifocal MB; Diffuse cerebellar swelling (DCS); Medulloblastoma (MB)
• ISSN: 0344-5607; 1437-2320
• DOI: 10.1007/s10143-014-0556-4

Medulloblastoma (MB), the most common malignant tumor typically affecting children, occurs only exceptionally in adults. Multifocal presentation of this malignancy in adulthood is even much rarer—only four cases with favorable postoperative course have been reported, so far. The study illustrates a very rare rapid postoperative clinical deterioration due to diffuse cerebellar swelling (DCS) in an adult multifocal MB (MMB). To the best of their knowledge, authors for the first time performed genetic analysis of MMB and demonstrated expression patterns of selected markers that put the patient within the sonic hedgehog (SHH) molecular subgroup and at least partially explain her unsatisfactory clinical course. Herein, authors summarized the relevant literature concerning this issue with the aim to determine features that would facilitate diagnosis and therapy of such a scarce clinical entity.