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Child's Nervous System

, Volume 34, Issue 9, pp 1619–1626 | Cite as

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

  • He Yue
  • Wang Ling
  • Ou Yibo
  • Wang Sheng
  • Tang Sicheng
  • Chen Jincao
  • Guo Dongsheng
Case-Based Update

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.

Keywords

Medulloblastoma Anterior skull base Recurrence 

Notes

Funding

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

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Supplementary material

381_2018_3869_MOESM1_ESM.docx (2.7 mb)
ESM 1 (DOCX 2725 kb)

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  • He Yue
    • 1
  • Wang Ling
    • 2
  • Ou Yibo
    • 1
  • Wang Sheng
    • 1
  • Tang Sicheng
    • 1
  • Chen Jincao
    • 3
  • Guo Dongsheng
    • 1
  1. 1.Department of Neurosurgery, Tongji Hospital, Tongji Medical CollegeHuazhong University of Science and TechnologyWuhanPeople’s Republic of China
  2. 2.Department of Operating room, Tongji Hospital, Tongji Medical CollegeHuazhong University of Science and TechnologyWuhanPeople’s Republic of China
  3. 3.Department of Neurosurgery, Zhongnan HospitalWuhan UniversityWuhanPeople’s Republic of China

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