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Child's Nervous System

, Volume 29, Issue 5, pp 821–832 | Cite as

Glioblastoma of the cerebellum in children: report of five cases and review of the literature

  • Gaddum D. Reddy
  • Anish N. Sen
  • Akash J. Patel
  • Robert J. Bollo
  • Andrew JeaEmail author
Original Paper

Abstract

Purpose

Cerebellar glioblastomas in children are rare. As a result, an optimal treatment strategy has not yet been identified. A review of the characteristics of the disease as well as the effectiveness of various therapeutic modalities would help in optimizing the treatment paradigm.

Methods

We performed a detailed clinical, radiographic, and pathologic retrospective review of five patients (three boys and two girls, average age at presentation 7.2 years (range, 3–14 years)) and surveyed the literature for an additional 55 cases.

Results

Computed tomography and magnetic resonance imaging usually revealed a large lesion with minimal edema, heterogeneous contrast enhancement, and a discrete border. Subtotal tumor resection was performed in two patients and gross total resection in three patients. Immunostaining of the tumor cells with antisera to glial fibrillary acidic protein and vimentin was variably positive. Adjuvant therapy included local radiation and chemotherapy in all followed patients. Tumor recurrence was seen in two patients. Patients were followed from 2 months to 3.5 years (mean, 12 months). Two patients were dead at last follow-up with a mean survival of 9.5 months.

Conclusions

The prognosis for pediatric patients with cerebellar glioblastomas is dismal, even when compared to adult counterparts or other malignant posterior fossa tumors in children. Cerebellar glioblastomas have a tendency to recur and disseminate despite treatment with surgery, chemotherapy, and radiation. The poor outcomes seen with this tumor suggest that the optimal treatment strategy has yet to be elucidated and much work needs to be done.

Keywords

Cerebellum Glioblastoma Children Posterior fossa 

References

  1. 1.
    Alpers CE, Davis RL, Wilson CB (1982) Persistence and late malignant transformation of childhood cerebellar astrocytoma. Case report. J Neurosurg 57:548–551PubMedCrossRefGoogle Scholar
  2. 2.
    Bristot R, Raco A, Vangelista T, Delfini R (1998) Malignant cerebellar astrocytomas in childhood. Experience with four cases. Childs Nerv Syst 14:532–536PubMedCrossRefGoogle Scholar
  3. 3.
    Campbell JW, Pollack IF (1996) Cerebellar astrocytomas in children. J Neurooncol 28:223–231PubMedCrossRefGoogle Scholar
  4. 4.
    Chamberlain MC, Silver P, Levin VA (1990) Poorly differentiated gliomas of the cerebellum. A study of 18 patients. Cancer 65:337–340PubMedCrossRefGoogle Scholar
  5. 5.
    Georges PM, Noterman J, Flament-Durand J (1983) Glioblastoma of the cerebellum in children and adolescents. Case report and review of the literature. J Neurooncol 1:275–278PubMedCrossRefGoogle Scholar
  6. 6.
    Greene GM, Hitchon PW, Schelper RL, Yuh W, Dyste GN (1989) Diagnostic yield in CT-guided stereotactic biopsy of gliomas. J Neurosurg 71:494–497PubMedCrossRefGoogle Scholar
  7. 7.
    Hayostek CJ, Shaw EG, Scheithauer B, O'Fallon JR, Weiland TL, Schomberg PJ, Kelly PJ, Hu TC (1993) Astrocytomas of the cerebellum. A comparative clinicopathologic study of pilocytic and diffuse astrocytomas. Cancer 72:856–869PubMedCrossRefGoogle Scholar
  8. 8.
    Itoh Y, Kowada M, Mineura K, Kojima H, Sageshima M (1988) Primary malignant astrocytoma of the cerebellum in children. Report of a case with electron microscopic and cytofluorometric DNA evaluation. Childs Nerv Syst 4:306–309PubMedGoogle Scholar
  9. 9.
    Katz DS, Poe LB, Winfield JA, Corona RJ Jr (1995) A rare case of cerebellar glioblastoma multiforme in childhood: MR imaging. Clin Imaging 19:162–164PubMedCrossRefGoogle Scholar
  10. 10.
    Kopelson G (1982) Cerebellar glioblastoma. Cancer 50:308–311PubMedCrossRefGoogle Scholar
  11. 11.
    Kulkarni AV, Becker LE, Jay V, Armstrong DC, Drake JM (1999) Primary cerebellar glioblastomas multiforme in children. Report of four cases. J Neurosurg 90:546–550PubMedCrossRefGoogle Scholar
  12. 12.
    Kuroiwa T, Numaguchi Y, Rothman MI, Zoarski GH, Morikawa M, Zagardo MT, Kristt DA (1995) Posterior fossa glioblastoma multiforme: MR findings. AJNR Am J Neuroradiol 16:583–589PubMedGoogle Scholar
  13. 13.
    Levine SA, McKeever PE, Greenberg HS (1987) Primary cerebellar glioblastoma multiforme. J Neurooncol 5:231–236PubMedCrossRefGoogle Scholar
  14. 14.
    Mahvash M, Hugo HH, Maslehaty H, Mehdorn HM, Stark AM (2011) Glioblastoma multiforme in children: report of 13 cases and review of the literature. Pediatr Neurol 45:178–180PubMedCrossRefGoogle Scholar
  15. 15.
    Pang D, Ashmead JW (1982) Extraneural metastasis of cerebellar glioblastoma multiforme. Neurosurgery 10:252–257PubMedCrossRefGoogle Scholar
  16. 16.
    Salazar OM (1981) Primary malignant cerebellar astrocytomas in children: a signal for postoperative craniospinal irradiation. Int J Radiat Oncol Biol Phys 7:1661–1665PubMedCrossRefGoogle Scholar
  17. 17.
    Shinoda J, Yamada H, Sakai N, Ando T, Hirata T, Hirayama H (1989) Malignant cerebellar astrocytic tumours in children. Acta Neurochir (Wien) 98:1–8CrossRefGoogle Scholar
  18. 18.
    Steinberg GK, Shuer LM, Conley FK, Hanbery JW (1985) Evolution and outcome in malignant astroglial neoplasms of the cerebellum. J Neurosurg 62:9–17PubMedCrossRefGoogle Scholar
  19. 19.
    Ushio Y, Arita N, Yoshimine T, Ikeda T, Mogami H (1987) Malignant recurrence of childhood cerebellar astrocytoma: case report. Neurosurgery 21:251–255PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2013

Authors and Affiliations

  • Gaddum D. Reddy
    • 1
  • Anish N. Sen
    • 1
  • Akash J. Patel
    • 1
  • Robert J. Bollo
    • 1
  • Andrew Jea
    • 1
    • 2
    Email author
  1. 1.Division of Pediatric Neurosurgery, Department of Neurosurgery, Texas Children’s HospitalBaylor College of MedicineHoustonUSA
  2. 2.Texas Children’s HospitalHoustonUSA

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