Medulloblastoma metastatic to the suprasellar region at diagnosis: a report of six cases with clinicopathologic correlation.
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.
Helton
Kathleen J
KJ
St. Jude Children's Research Hospital, Semmes-Murphy Clinic, Memphis, TN 38105, USA. kathleen.helton@stjude.org
Gajjar
Amar
A
Hill
D Ashley
DA
Boop
Frederick A
FA
Kun
Larry E
LE
Langston
James W
JW
D001932:Brain Neoplasms / Q000134:cerebrospinal fluid / Q000556:secondary* / Q000628:therapy; D001933:Brain Stem / Q000473:pathology; D002528:Cerebellar Neoplasms / Q000134:cerebrospinal fluid / Q000175:diagnosis / Q000473:pathology*; D002574:Cervical Vertebrae / Q000473:pathology; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008159:Lumbar Vertebrae / Q000473:pathology; D008279:Magnetic Resonance Imaging; D008297:Male; D008527:Medulloblastoma / Q000134:cerebrospinal fluid / Q000175:diagnosis / Q000473:pathology*; D008577:Meningeal Neoplasms / Q000556:secondary; D009362:Neoplasm Metastasis; D009367:Neoplasm Staging; D013125:Spinal Neoplasms / Q000556:secondary; D020542:Third Ventricle / Q000473:pathology*; D013904:Thoracic Vertebrae