title: The Neuroradiological Spectra of Adult and Pediatric Medulloblastoma Differ : Results from a Literature-based Meta-analysis.
abstract: OBJECTIVE
  Current knowledge on the spectrum of the neuroradiological appearance of adult medulloblastoma is sparse. Due to the rarity of the disease, adult patients were generally diagnosed and treated similar to children; however, pediatric and adult medulloblastomas display substantial molecular differences that may influence the neuroradiological phenotype. This study therefore aimed at assessment of the neuroradiological spectrum of adult medulloblastoma in comparison to pediatric tumors.
  
  
  METHODS
  All available publications on adult medulloblastoma published until June 2013 were screened for imaging data on single patients. A total of 109 patients were identified and compared to 118 pediatric patients described in 4 cohorts.
  
  
  RESULTS
  The average age of the adult patients was 34.3 years. Most adult medulloblastomas (57.6 %) were localized laterally (vs. 14.4 % in pediatric patients). On T1-weighted sequences, only 41.1 % of all adult medulloblastomas appeared hypointense (vs. 89.3 %) and 69.6 % were hyperintense on T2 sequences (vs. 83 %). In contrast to pediatric patients only 53.3 % showed strong contrast enhancement (pediatric patients 77.1 %), while the contrast uptake of the remainder was described as subtle, moderate or lacking. Contrast enhancement was more often described as inhomogeneous in adults (35.5 % as compared to 15.2 % in children) and 26.4 % had cysts.
  
  
  CONCLUSIONS
  Although the neuroradiological spectrum of medulloblastoma in adults was similar to children, an atypical presentation with inhomogeneous contrast enhancement, more hyperintense signal on T1 and a more hypointense signal on T2-weighted sequences was common. Given the rarity of the tumor, awareness of these differences constitutes a prerequisite to avoid delays in diagnostics.
authors.affiliation: Department of Clinical Research, University of Southern Denmark, Sdr. Boulevard 29, 5000, Odense, Denmark. dagmar.beier@rsyd.dk.|Department of Neurology, University Hospital of Odense, Sdr. Boulevard 29, 5000, Odense, Denmark. dagmar.beier@rsyd.dk.|Department of Neurology, University Hospital Aachen, Pauwelsstraße 20, 52074, Aachen, Germany. dagmar.beier@rsyd.dk.
authors.forename: Dagmar
authors.initials: D
authors.lastname: Beier
authors.affiliation: Department of Neurology, University Hospital Aachen, Pauwelsstraße 20, 52074, Aachen, Germany.
authors.forename: Selin
authors.initials: S
authors.lastname: Kocakaya
authors.affiliation: Wilhelm Sander NeuroOncology Unit and Department of Neurology, University Hospital Regensburg, Universitätsstraße 80, 93053, Regensburg, Germany.
authors.forename: Peter
authors.initials: P
authors.lastname: Hau
authors.affiliation: Department of Clinical Research, University of Southern Denmark, Sdr. Boulevard 29, 5000, Odense, Denmark.|Department of Neurology, University Hospital of Odense, Sdr. Boulevard 29, 5000, Odense, Denmark.|Department of Neurology, University Hospital Aachen, Pauwelsstraße 20, 52074, Aachen, Germany.
authors.forename: Christoph Patrick
authors.initials: CP
authors.lastname: Beier
mesh_terms: D000328:Adult; D002528:Cerebellar Neoplasms / Q000000981:diagnostic imaging*; D002648:Child; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008527:Medulloblastoma / Q000000981:diagnostic imaging*
keywords: Adult; Computed tomography; Contrast enhancement; Magnetic resonance imaging; Medulloblastoma