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Medulloblastoma metastatic to the marrow

Report of four cases and review of the literature

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Summary

Medulloblastoma is a malignant cerebellar tumor seen primarily in the pediatric age group that has a known ability to metastasize extraneurally. The skeleton is the most common site of extraneural metastases, but metastases to the bone marrow can also occur. Four cases of medulloblastoma metastatic to the marrow are reported. In addition, 31 cases from the medical literature are reviewed. Clinical features include bone tenderness, cytopenias and elevated serum alkaline phosphatase and lactic dehydrogenase levels. Skeletal involvement, especially of the pelvic bones, is frequently seen radiographically. Weight loss, soft tissue masses and a requirement for blood transfusion are also associated features. Marrow biopsy specimens are characterized by the presence of a small cell tumor often with fibrosis, necrosis and osteoblastic activity. The symptomatic response to chemotherapy is rapid, but chemotherapy resistance appears quickly. Only 1 in 4 cases diagnosed antemortem in this review lived for more than a year. We conclude that marrow aspiration and biopsy are indicated in the evaluation of patients with medulloblastoma and may serve to diagnose the cause of cytopenias, to verify extraneural spread and to provide prognostic information.

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Authors and Affiliations

  1. From the Section of Medical Oncology, Walter Reed Army Medical Center, Washington, DC

    Cory D Spencer

  2. the Uniformed Services University of the Health Sciences, Bethesda, MD

    Raymond B Weiss

  3. MD Anderson Hospital, Houston, TX

    Jan Van Eys

  4. George Washington University Hospital, Washington DC

    Philip Cohen

  5. Operations Research Branch, Division of Cancer Prevention and Control, National Cancer Institute, Bethesda, MD, USA

    Brenda Edwards

Authors
  1. Cory D Spencer
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  2. Raymond B Weiss
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  3. Jan Van Eys
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  4. Philip Cohen
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  5. Brenda Edwards
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Spencer, C.D., Weiss, R.B., Van Eys, J. et al. Medulloblastoma metastatic to the marrow. J Neuro-Oncol 2, 223–235 (1984). https://doi.org/10.1007/BF00253274

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  • DOI: https://doi.org/10.1007/BF00253274

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