[Medulloblastoma presenting as an extra-axial tumor in the cerebellopontine angle]

Neurocirugia (Astur). 2004 Jun;15(3):285-9. doi: 10.1016/s1130-1473(04)70485-6.
[Article in Spanish]

Abstract

Differences in the imaging characteristic of adult medulloblastomas have been reported, including involvement of lateral cerebellar hemispheres with an extra-axial appearance. We present a case report of this rare circumstance: a 40 year old man presented with a 3 weeks history of headache, morning vomiting and left hearing difficulties. Magnetic resonance imaging revealed a left cerebellopontine angle (CPA) tumor, like a well circumscribed homogeneously enhancing mass. Through a left suboccipital craniectomy the tumor was totally removed. It presented as a cerebellopontine angle tumor, like a meningioma, and not as an intra-axial tumor. Histological analysis revealed that the tumor was composed of densely packed with highly proliferative cells that produce a dense intercellular reticulin fiber network. Inmunohistochemical analysis showed positive expression to synaptophysin, specific neuronal enolase and cromogranin. Histological diagnosis was crucial to define it as a desmoplastic medulloblastoma the present case and to perform postoperative adjuvant therapy. Neurosurgeons should be aware of the possibility that a CPA tumor is of intraaxial origin, because this increase the variability on pathological diagnosis.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Cerebellar Neoplasms / diagnostic imaging*
  • Cerebellar Neoplasms / pathology*
  • Cerebellar Neoplasms / surgery
  • Cerebellopontine Angle / diagnostic imaging*
  • Cerebellopontine Angle / pathology*
  • Cerebellopontine Angle / surgery
  • Humans
  • Magnetic Resonance Imaging
  • Male
  • Medulloblastoma / diagnostic imaging*
  • Medulloblastoma / pathology*
  • Medulloblastoma / surgery
  • Spinal Neoplasms / diagnosis
  • Spinal Neoplasms / diagnostic imaging
  • Spinal Neoplasms / secondary
  • Tomography, X-Ray Computed