title: Medulloblastoma with suprasellar solitary massive metastasis: Case report.
abstract: It is extremely rare for metastasised medulloblastoma to form a large tumour in the suprasellar region. We present a case of medulloblastoma with large suprasellar metastasis at initial presentation. A 3-year and 5-month-old boy presented with a 1-month history of vomiting and loss of appetite, and body weight. Computed tomography and magnetic resonance imaging revealed a 20 mm × 20 mm mass in the suprasellar region and a 30 mm × 30 mm mass in the fourth cerebral ventricle. We performed endoscopic biopsy of the suprasellar tumour, and subsequently totally removed the vermian tumour through a suboccipital craniotomy. The histopathological findings revealed that both the suprasellar and vermian tumours were classic type and non SHH/WNT type medulloblastoma. The postoperative course was uneventful. The patient showed complete remission after chemotherapy. The tumour in the suprasellar region was most likely metastatic from the vermis. Endoscopic biopsy of the tumour in the suprasellar region and total removal of the tumour in the vermis in a one-stage operation followed by intensive chemotherapy with reduced dose radiotherapy may provide a satisfactory outcome.
authors.affiliation: Department of Neurosurgery, Hyogo Prefectural Kobe Children's Hospital, Kobe, Japan; Department of Neurosurgery, Kobe University Graduate School of Medicine, Kobe, Japan. Electronic address: hn0628hn@med.kobe-u.ac.jp.
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Nagashima
authors.affiliation: Department of Neurosurgery, Hyogo Prefectural Kobe Children's Hospital, Kobe, Japan.
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Nagashima
authors.affiliation: Department of Neurosurgery, Hyogo Prefectural Kobe Children's Hospital, Kobe, Japan.
authors.forename: Atsufumi
authors.initials: A
authors.lastname: Kawamura
authors.affiliation: Department of Neurosurgery, Hyogo Prefectural Kobe Children's Hospital, Kobe, Japan.
authors.forename: Kazuki
authors.initials: K
authors.lastname: Yamamoto
authors.affiliation: Department of Pathology, Hyogo Prefectural Kobe Children's Hospital, Kobe, Japan.
authors.forename: Makiko
authors.initials: M
authors.lastname: Yoshida
authors.affiliation: Department of Hematology-Oncology, Hyogo Prefectural Kobe Children's Hospital, Kobe, Japan.
authors.forename: Daiichiro
authors.initials: D
authors.lastname: Hasegawa
authors.affiliation: Department of Hematology-Oncology, Hyogo Prefectural Kobe Children's Hospital, Kobe, Japan.
authors.forename: Yoshiyuki
authors.initials: Y
authors.lastname: Kosaka
authors.affiliation: Department of Neurosurgery, Kobe University Graduate School of Medicine, Kobe, Japan.
authors.forename: Eiji
authors.initials: E
authors.lastname: Kohmura
mesh_terms: D002528:Cerebellar Neoplasms / Q000473:pathology*; D065814:Cerebellar Vermis / Q000473:pathology*; D002675:Child, Preschool; D006801:Humans; D008297:Male; D008527:Medulloblastoma / Q000473:pathology*; D009362:Neoplasm Metastasis / Q000473:pathology; D012658:Sella Turcica / Q000473:pathology
keywords: Medulloblastoma; Metastasis; Suprasellar region