title: Anaplasia is rare and does not influence prognosis in adult medulloblastoma.
abstract: Histopathologic grading based on increasing anaplasia predicts clinical behavior of pediatric medulloblastomas. The present study was aimed at grading 86 medulloblastomas of adult patients (aged 18 and older) by anaplasia and analyzing the predictive power. Nodularity, desmoplasia, nuclear size, nuclear pleomorphism, necrosis, and endothelial proliferations have been evaluated. Morphometric analysis of nuclear size was performed using the Eclipse Net program. Patients treated with standard postoperative radiotherapy (35 Gy to craniospinal axis and 50 Gy to posterior fossa) were considered for correlation with survival. Pathologic data and total survival were compared by Kaplan-Meier and logrank analysis. No correlation was found between total survival duration and individual pathologic features. Cooccurrence of nuclear pleomorphism, large nuclear diameter, microvascular proliferations, and necroses did not predict outcome. Severe nuclear pleomorphism was found in 4 of 86 cases; the only large-cell medulloblastoma was from an 18-year-old patient. Histopathologic factors have no clinical use for stratification of patients in risk groups. The histologic spectrum of medulloblastoma in adults is different from that in children.
authors.affiliation: Department of Neuroscience, University of Torino, Torino, Italy. mariateresa.giordana@unito.it
authors.forename: Maria Teresa
authors.initials: MT
authors.lastname: Giordana
authors.forename: Carla
authors.initials: C
authors.lastname: D'Agostino
authors.forename: Bianca
authors.initials: B
authors.lastname: Pollo
authors.forename: Antonio
authors.initials: A
authors.lastname: Silvani
authors.forename: Romano
authors.initials: R
authors.lastname: Ferracini
authors.forename: Anna
authors.initials: A
authors.lastname: Paiolo
authors.forename: Paolo
authors.initials: P
authors.lastname: Ghiglione
authors.forename: Adriano
authors.initials: A
authors.lastname: Chiò
mesh_terms: D000328:Adult; D000368:Aged; D000708:Anaplasia; D002528:Cerebellar Neoplasms / Q000473:pathology*; D005260:Female; D006801:Humans; D008297:Male; D008527:Medulloblastoma / Q000473:pathology*; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D016019:Survival Analysis