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Subfrontal recurrence after cerebellar medulloblastoma resection without local relapse: case-based update

  • Case-Based Update
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Abstract

Objective

This report detailed four cases of tumor recurrence in the subfrontal region after cerebellar medulloblastoma resection without local relapse and explored the causes of recurrence. In addition, a case-based update and insight into the entity is attempted.

Methods

All four patients received cerebellar medulloblastoma resection and postoperative radiotherapy. They were admitted to our hospital when they were found to have a recurrent tumor in the subfrontal region of the anterior skull base. All four patients received re-resection of the tumor, which was confirmed to be recurrent medulloblastoma by postoperative pathological results.

Results

All patients received local radiotherapy and temozolomide chemotherapy after recurrent tumor resection. They all died due to multiple organ failure resulting from tumor metastasis to other sites or tumor regrowth within 2 years after the second operation.

Conclusion

Medulloblastoma metastasize to the subfrontal region and develop a homogenous recurrence is rare. Underdosage of radiation, a gravity-related sanctuary effect, surgical position, and perioperative hydrocephalus management might be factors contributing to this supratentorial meningeal recurrence. A better prevention of tumor recurrence might be achieved by extensive microsurgical tumor resection in the initial operation and by minimizing the need for a permanent V-P shunt in the treatment of perioperative hydrocephalus as well as by administering full-dose radiotherapy to the region of the cribriform plate in the subfrontal area.

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Funding

This study was supported partially by a grant from the National Natural Science Foundation of China No.81671154 to Dr. He.

Author information

Authors and Affiliations

  1. Department of Neurosurgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, People’s Republic of China

    He Yue, Ou Yibo, Wang Sheng, Tang Sicheng & Guo Dongsheng

  2. Department of Operating room, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, People’s Republic of China

    Wang Ling

  3. Department of Neurosurgery, Zhongnan Hospital, Wuhan University, Wuhan, 430071, People’s Republic of China

    Chen Jincao

Authors
  1. He Yue
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  2. Wang Ling
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  3. Ou Yibo
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  4. Wang Sheng
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  5. Tang Sicheng
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  6. Chen Jincao
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  7. Guo Dongsheng
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Correspondence to Guo Dongsheng.

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The authors declare that they have no conflict of interest.

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Yue, H., Ling, W., Yibo, O. et al. Subfrontal recurrence after cerebellar medulloblastoma resection without local relapse: case-based update. Childs Nerv Syst 34, 1619–1626 (2018). https://doi.org/10.1007/s00381-018-3869-8

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  • DOI: https://doi.org/10.1007/s00381-018-3869-8

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