title: Frontal recurrence of medulloblastoma five years after excision and craniospinal irradiation.
abstract: Medulloblastomas were originally classified under gliomas of the cerebellum until Bailey and Cushing in 1925 named these tumors as medulloblastoma. At present these tumors are classified under primitive neuroectodermal tumor. Surgical excision followed by craniospinal irradiation is the treatment of choice. A 13-year-old-girl operated for posterior fossa medulloblastoma 5 years ago presented with history of headache and vomiting on and off for 4 days in late August 2008. The MRI showed left frontal tumor which on excision was reported as medulloblastoma. Even after optimal treatment reports of recurrence abound in literature. The most common location is in the posterior fossa, followed by spinal, supratentorial, and uncommonly, systemic metastases. We conclude that medulloblastomas are highly aggressive tumor with high local recurrences if the initial excision is incomplete and that recurrence in the supratentorial area although uncommon is still a possibility. This mandates regular follow up of these children till adulthood to catch early recurrences and metastatic disease.
authors.affiliation: National Neurosurgical Referral Centre, National Academy of Medical Sciences, Bir Hospital, Kathmandu, Nepal. dryamroka@yahoo.com
authors.forename: Y B
authors.initials: YB
authors.lastname: Roka
authors.forename: P
authors.initials: P
authors.lastname: Bista
authors.forename: G R
authors.initials: GR
authors.lastname: Sharma
authors.forename: D
authors.initials: D
authors.lastname: Adhikari
authors.forename: P
authors.initials: P
authors.lastname: Kumar
mesh_terms: D000293:Adolescent; D000818:Animals; D001921:Brain / Q000000981:diagnostic imaging / Q000473:pathology; D005260:Female; D006651:Histocytochemistry; D006801:Humans; D008279:Magnetic Resonance Imaging; D008527:Medulloblastoma / Q000175:diagnosis* / Q000473:pathology*; D011859:Radiography; D012008:Recurrence