Lipomatous medulloblastoma: a rare adult tumor variant with a uniquely favorable prognosis.
BACKGROUND
Lipomatous medulloblastoma is a rare but apparently distinct variant of medulloblastoma. There have been only 14 prior published cases. We report an additional case of an adult who presented with a multicentric form of this unique lesion.


METHODS
A 45-year-old woman underwent magnetic resonance imaging for evaluation of progressive headaches, nausea/vomiting, vertigo, and ataxia. Multiple bilateral mass lesions in the posterior fossa were noted, along with obstructive hydrocephalus and significant mass effect.


RESULTS
Via a right suboccipital and retrosigmoid craniotomy the largest cerebellar lesion was resected and a second lesion biopsied. The third mass on the contralateral side was not disturbed. Postoperatively the patient received fractionated radiotherapy to a dose of 54 Gy and chemotherapy with cisplatin, PCNU, and vincristine for 1 year. She is alive without deficit, with a Karnofsky Performance Status of 100, and with no evidence of disease on neuroimaging 3 years after diagnosis.


CONCLUSIONS
This distinct variant of medulloblastoma appears to occur in adults only and has a uniquely favorable prognosis, even with incomplete resection with institution of appropriate adjuvant therapies. Multicentricity does not imply a less favorable prognosis.
Elshihabi
Said
S
Department of Neurological Surgery, Little Rock, Arkansas 72205, USA.
Husain
Muhammad
M
Linskey
Mark
M
D000368:Aged; D002528:Cerebellar Neoplasms / Q000175:diagnosis* / Q000628:therapy*; D005260:Female; D006801:Humans; D008068:Lipomatosis / Q000175:diagnosis* / Q000628:therapy*; D008527:Medulloblastoma / Q000175:diagnosis* / Q000628:therapy*; D011379:Prognosis