Medulloblastoma: Diagnosis and Treatment

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

To get an accurate diagnosis, a piece of tumor tissue will be removed during surgery, if possible. A neuropathologist should then review the tumor tissue.

What Are the Grades of Medulloblastomas?

Primary CNS tumors are graded based on a tumor tissue analysis performed by a neuropathologist. Medulloblastomas are all classified as grade 4 (also written as grade IV) tumors. This means they are malignant (cancerous) and fast-growing.

Additionally, medulloblastomas need staging—obtaining tests to detect if the tumor has spread to other areas of the CNS or outside the CNS. Using the stage of the cancer, the patient’s age, and whether the tumor remains after surgery (if surgery is possible), a health care team can estimate the risk of the tumor coming back. This also helps them decide on the best treatment. This process is called risk stratification, and medulloblastomas are classified into two risk groups: standard risk (or average risk) and high risk.

Currently, medulloblastomas are also classified based on their genetic features. There are at least four subgroups that have been identified in children and adults, although their frequency and genetic features vary depending on the age of the patient:

  • WNT-activated
  • SHH-activated
  • Group 3 (non-WNT / non-SHH)
  • Group 4 (non-WNT / non-SHH)

Where Do Medulloblastomas Form?

Medulloblastomas most commonly form in the cerebellum, the bottom part of the brain located at the back of the skull. Medulloblastomas are known as embryonal neuroepithelial tumors, because they form in fetal cells that remain after birth.

What Are the Symptoms of a Medulloblastoma?

Symptoms related to a medulloblastoma depend on the tumor’s location. Here are some possible symptoms that can occur.

People with a medulloblastoma in the cerebellum may have:

  • Issues with walking, balance, and/or fine motor skills

If the tumor is causing hydrocephalus, signs and symptoms may include:

  • Headaches
  • Nausea
  • Vomiting
  • Blurred and double vision
  • Extreme sleepiness
  • Confusion
  • Seizures and even passing out

If a 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
  • Spinal pain

If a medulloblastoma has spread to other organs, symptoms may include:

  • Coughing, chest pain, and shortness of breath
  • Enlarged lymph nodes
  • Bone pain

Who Is Diagnosed with a Medulloblastoma?

Seventy percent of medulloblastoma cases occur in children and 30 percent occur in adults. In adults, medulloblastoma typically affects those between 20 and 40 years of age.

Medulloblastomas occur more often in males than females. They are most common in non-Hispanic white and Hispanic people. An estimated 6,070 people are living with this tumor in the United States.

 

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