Diagnosis and treatment of adult medulloblastoma seeding in the intracranial-spinal subarachnoid space

• Main Authors: Ji-wei WANG, Bu-dong CHEN, Yu-shan YANG, Xin YAO
• Format: Article
• Language: English
• Published: Tianjin Huanhu Hospital 2015-10-01
• Series: Chinese Journal of Contemporary Neurology and Neurosurgery
• Subjects: Medulloblastoma; Neoplasm seeding; Meninges; Adult
• Online Access: http://www.cjcnn.org/index.php/cjcnn/article/view/1291

<p><strong>Objective </strong>To investigate the clinical diagnosis and treatment of adult medulloblastoma seeding in the intracranial-spinal subarachnoid space. <strong>Methods</strong> Eleven cases of adult medulloblastoma seeding in the intracranial-spinal subarachnoid space were retrospectively analyzed on the clinical features, cerebrospinal fluid (CSF) cytology, radiological characteristics and treatments. <strong>Results</strong> All patients underment neurosurgical procedures to remove medulloblastomas. In 10 patients, tumor was removed through suboccipital posterior midline approach and in one patient through post-sigmoid sinus approach. In 7 patients tumor cell seeding was found in the intracranial-spinal subarachnoid space before postoperative radiotherapy and disappeared after radiological and chemical treatment, while in other 4 patients tumor cell seeding was found in the intracranial-spinal subarachnoid space at 3 months to 3 years follow-up period (average 20 months) after radiotherapy. In 2 of all the patients tumor cells were found by CSF cytology before operation. All the patients were treated with radiotherapy and adjuvant chemotherapy. Two patients were still alive, while 9 patients were dead. <strong>Conclusions</strong> Patients with adult medulloblastoma seeding in intracranial-spinal subarachnoid space have a poor prognosis. In the diagnosis of adult medulloblastomas seeding in the intracranial-spinal subarachnoid space, MRI is more sensitive than CSF cytology. Once the seeding in intracranial-spinal subarachnoid space was found, the patients should be treated with radiotherapy and adjuvant chemotherapy, which can prolong the survival time and improve the quality of life.</p><p> </p><p><strong>DOI: </strong>10.3969/j.issn.1672-6731.2015.10.012</p><p> </p>