Medulloblastoma metastatic to the suprasellar region at diagnosis: a report of six cases with clinicopathologic correlation

Pediatr Neurosurg. 2002 Sep;37(3):111-7. doi: 10.1159/000064392.

Abstract

The presence of metastatic disease in patients newly diagnosed with medulloblastoma remains one of the most important prognostic factors that determines event-free survival. In the present study, anatomic distribution and the signal characteristics and enhancement patterns of subtle anterior third ventricular recess metastases were compared with those of the original tumor; medical records were reviewed for clinical presentation, surgical stage, treatment and long-term outcomes. All foci were clinically occult; 5 out of 6 had negative cerebrospinal fluid cytology, and in 4 out of 6, the only evidence of metastatic disease was documented suprasellar disease that resolved or significantly improved following irradiation and chemotherapy. Histologically, 3 of the 6 patients had tumors with large cell/anaplastic features, a significant increase compared to the expected incidence of 4-8.8%. Patients with tumors that show large cell/anaplastic features may be at higher risk for early metastatic involvement of this unusual site.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Brain Neoplasms / cerebrospinal fluid
  • Brain Neoplasms / secondary*
  • Brain Neoplasms / therapy
  • Brain Stem / pathology
  • Cerebellar Neoplasms / cerebrospinal fluid
  • Cerebellar Neoplasms / diagnosis
  • Cerebellar Neoplasms / pathology*
  • Cervical Vertebrae / pathology
  • Child
  • Child, Preschool
  • Female
  • Humans
  • Lumbar Vertebrae / pathology
  • Magnetic Resonance Imaging
  • Male
  • Medulloblastoma / cerebrospinal fluid
  • Medulloblastoma / diagnosis
  • Medulloblastoma / pathology*
  • Meningeal Neoplasms / secondary
  • Neoplasm Metastasis
  • Neoplasm Staging
  • Spinal Neoplasms / secondary
  • Third Ventricle / pathology*
  • Thoracic Vertebrae