title: Urgent radiotherapy is effective in the treatment of metastatic medulloblastoma causing symptomatic brainstem edema.
abstract: A 3-year-old male who presented with hydrocephalus symptoms was found to have metastatic medulloblastoma with diffuse spinal disease. Thirteen days following surgical resection of his primary tumor, he clinically deteriorated due to worsening brainstem edema. Following intubation, stress-dose steroids, and mannitol, urgent radiotherapy was initiated to the whole brain and cervical cord. The patient improved clinically with a repeat MRI showing decreased leptomeningeal enhancement in the radiation fields. In the literature, there are no reports of successful urgent radiotherapy in medulloblastoma, but in this instance, it proved to be a viable option.
authors.affiliation: Indiana University School of Medicine, Department of Radiation Oncology, Indianapolis, Indiana 46202, USA.
authors.forename: Ronald H
authors.initials: RH
authors.lastname: Shapiro
authors.forename: Andrew L
authors.initials: AL
authors.lastname: Chang
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001929:Brain Edema / Q000150:complications* / Q000188:drug therapy / Q000532:radiotherapy; D002528:Cerebellar Neoplasms / Q000150:complications / Q000188:drug therapy / Q000473:pathology / Q000532:radiotherapy*; D002675:Child, Preschool; D006801:Humans; D008297:Male; D008527:Medulloblastoma / Q000150:complications / Q000188:drug therapy / Q000532:radiotherapy* / Q000556:secondary*; D013125:Spinal Neoplasms / Q000188:drug therapy / Q000532:radiotherapy* / Q000556:secondary; D016896:Treatment Outcome