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Medulloblastoma
Luke L. Linscott, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Pathology

          • Clinical Issues

            • Diagnostic Checklist

              TERMINOLOGY

              • Abbreviations

                • Medulloblastoma (MB)
              • Synonyms

                • Previously referred to as posterior fossa primitive neuroectodermal tumor (PNET), PNET-MB
                  • MB histologically similar to PNET but biologically distinct
                  • MB distinguished from PNET by i17q, loss of 17p, alterations of sonic hedgehog (SHH) and wingless (Wnt) pathways, pattern of DNA methylation
              • Definitions

                • Malignant (WHO grade IV), invasive, highly cellular embryonal tumor

              IMAGING

              • General Features

                • CT Findings

                  • MR Findings

                    • Nuclear Medicine Findings

                      • Imaging Recommendations

                        DIFFERENTIAL DIAGNOSIS

                          PATHOLOGY

                          • General Features

                            • Staging, Grading, & Classification

                              • Microscopic Features

                                CLINICAL ISSUES

                                • Presentation

                                  • Demographics

                                    • Natural History & Prognosis

                                      • Treatment

                                        DIAGNOSTIC CHECKLIST

                                        • Consider

                                          • Image Interpretation Pearls

                                            Selected References

                                            1. Cassia GSE et al: Childhood medulloblastoma revisited. Top Magn Reson Imaging. 27(6):479-502, 2018
                                            2. Shih RY et al: Embryonal tumors of the central nervous system: from the radiologic pathology archives. Radiographics. 38(2):525-41, 2018
                                            3. Schwalbe EC et al: Novel molecular subgroups for clinical classification and outcome prediction in childhood medulloblastoma: a cohort study. Lancet Oncol. 18(7):958-71, 2017
                                            4. Raybaud C et al: Posterior fossa tumors in children: developmental anatomy and diagnostic imaging. Childs Nerv Syst. 31(10):1661-76, 2015
                                            5. Wong TT et al: Factors affecting survival of medulloblastoma in children: the changing concept of management. Childs Nerv Syst. 31(10):1687-98, 2015
                                            6. Ostrom QT et al: CBTRUS statistical report: primary brain and central nervous system tumors diagnosed in the United States in 2007-2011. Neuro Oncol. 16 Suppl 4:iv1-63, 2014
                                            7. Perreault S et al: MRI surrogates for molecular subgroups of medulloblastoma. AJNR Am J Neuroradiol. 35(7):1263-9, 2014
                                            8. Pierce TT et al: Evaluation of apparent diffusion coefficient thresholds for diagnosis of medulloblastoma using diffusion-weighted imaging. Neuroradiol J. 27(1):63-74, 2014
                                            9. Pierce T et al: Use of apparent diffusion coefficient values for diagnosis of pediatric posterior fossa tumors. Neuroradiol J. 27(2):233-44, 2014
                                            10. Plaza MJ et al: Conventional and advanced MRI features of pediatric intracranial tumors: posterior fossa and suprasellar tumors. AJR Am J Roentgenol. 200(5):1115-24, 2013
                                            11. Yeom KW et al: Distinctive MRI features of pediatric medulloblastoma subtypes. AJR Am J Roentgenol. 200(4):895-903, 2013
                                            12. Poretti A et al: Neuroimaging of pediatric posterior fossa tumors including review of the literature. J Magn Reson Imaging. 35(1):32-47, 2012
                                            13. Craver R et al: Medulloblastoma variants and survival at a children's hospital. Fetal Pediatr Pathol. 30(1):53-9, 2011
                                            14. Eran A et al: Medulloblastoma: atypical CT and MRI findings in children. Pediatr Radiol. 40(7):1254-62, 2010
                                            15. Jaremko JL et al: Value and limitations of diffusion-weighted imaging in grading and diagnosis of pediatric posterior fossa tumors. AJNR Am J Neuroradiol. 2010 Oct;31(9):1613-6. Epub 2010 Jun 10. Erratum in: AJNR Am J Neuroradiol. 31(10):E90, 2010
                                            16. Louis DN et al: The 2007 WHO classification of tumours of the central nervous system. Acta Neuropathol. 114(2):97-109, 2007
                                            17. Gururangan S et al: [18F]Fluorodeoxyglucose-positron emission tomography in patients with medulloblastoma. Neurosurgery. 55(6):1280-9, 2004
                                            18. Koeller KK et al: From the archives of the AFIP: medulloblastoma: a comprehensive review with radiologic-pathologic correlation. Radiographics. 23(6):1613-37, 2003
                                            19. Meyers SP et al: Postoperative evaluation for disseminated medulloblastoma involving the spine: contrast-enhanced MR findings, CSF cytologic analysis, timing of disease occurrence, and patient outcomes. AJNR Am J Neuroradiol. 21(9):1757-65, 2000
                                            20. Tortori-Donati P et al: Medulloblastoma in children: CT and MRI findings. Neuroradiology. 38(4):352-9, 1996
                                            Related Anatomy
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                                            Related Differential Diagnoses
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                                            References
                                            Tables

                                            Tables

                                            KEY FACTS

                                            • Terminology

                                              • Imaging

                                                • Top Differential Diagnoses

                                                  • Pathology

                                                    • Clinical Issues

                                                      • Diagnostic Checklist

                                                        TERMINOLOGY

                                                        • Abbreviations

                                                          • Medulloblastoma (MB)
                                                        • Synonyms

                                                          • Previously referred to as posterior fossa primitive neuroectodermal tumor (PNET), PNET-MB
                                                            • MB histologically similar to PNET but biologically distinct
                                                            • MB distinguished from PNET by i17q, loss of 17p, alterations of sonic hedgehog (SHH) and wingless (Wnt) pathways, pattern of DNA methylation
                                                        • Definitions

                                                          • Malignant (WHO grade IV), invasive, highly cellular embryonal tumor

                                                        IMAGING

                                                        • General Features

                                                          • CT Findings

                                                            • MR Findings

                                                              • Nuclear Medicine Findings

                                                                • Imaging Recommendations

                                                                  DIFFERENTIAL DIAGNOSIS

                                                                    PATHOLOGY

                                                                    • General Features

                                                                      • Staging, Grading, & Classification

                                                                        • Microscopic Features

                                                                          CLINICAL ISSUES

                                                                          • Presentation

                                                                            • Demographics

                                                                              • Natural History & Prognosis

                                                                                • Treatment

                                                                                  DIAGNOSTIC CHECKLIST

                                                                                  • Consider

                                                                                    • Image Interpretation Pearls

                                                                                      Selected References

                                                                                      1. Cassia GSE et al: Childhood medulloblastoma revisited. Top Magn Reson Imaging. 27(6):479-502, 2018
                                                                                      2. Shih RY et al: Embryonal tumors of the central nervous system: from the radiologic pathology archives. Radiographics. 38(2):525-41, 2018
                                                                                      3. Schwalbe EC et al: Novel molecular subgroups for clinical classification and outcome prediction in childhood medulloblastoma: a cohort study. Lancet Oncol. 18(7):958-71, 2017
                                                                                      4. Raybaud C et al: Posterior fossa tumors in children: developmental anatomy and diagnostic imaging. Childs Nerv Syst. 31(10):1661-76, 2015
                                                                                      5. Wong TT et al: Factors affecting survival of medulloblastoma in children: the changing concept of management. Childs Nerv Syst. 31(10):1687-98, 2015
                                                                                      6. Ostrom QT et al: CBTRUS statistical report: primary brain and central nervous system tumors diagnosed in the United States in 2007-2011. Neuro Oncol. 16 Suppl 4:iv1-63, 2014
                                                                                      7. Perreault S et al: MRI surrogates for molecular subgroups of medulloblastoma. AJNR Am J Neuroradiol. 35(7):1263-9, 2014
                                                                                      8. Pierce TT et al: Evaluation of apparent diffusion coefficient thresholds for diagnosis of medulloblastoma using diffusion-weighted imaging. Neuroradiol J. 27(1):63-74, 2014
                                                                                      9. Pierce T et al: Use of apparent diffusion coefficient values for diagnosis of pediatric posterior fossa tumors. Neuroradiol J. 27(2):233-44, 2014
                                                                                      10. Plaza MJ et al: Conventional and advanced MRI features of pediatric intracranial tumors: posterior fossa and suprasellar tumors. AJR Am J Roentgenol. 200(5):1115-24, 2013
                                                                                      11. Yeom KW et al: Distinctive MRI features of pediatric medulloblastoma subtypes. AJR Am J Roentgenol. 200(4):895-903, 2013
                                                                                      12. Poretti A et al: Neuroimaging of pediatric posterior fossa tumors including review of the literature. J Magn Reson Imaging. 35(1):32-47, 2012
                                                                                      13. Craver R et al: Medulloblastoma variants and survival at a children's hospital. Fetal Pediatr Pathol. 30(1):53-9, 2011
                                                                                      14. Eran A et al: Medulloblastoma: atypical CT and MRI findings in children. Pediatr Radiol. 40(7):1254-62, 2010
                                                                                      15. Jaremko JL et al: Value and limitations of diffusion-weighted imaging in grading and diagnosis of pediatric posterior fossa tumors. AJNR Am J Neuroradiol. 2010 Oct;31(9):1613-6. Epub 2010 Jun 10. Erratum in: AJNR Am J Neuroradiol. 31(10):E90, 2010
                                                                                      16. Louis DN et al: The 2007 WHO classification of tumours of the central nervous system. Acta Neuropathol. 114(2):97-109, 2007
                                                                                      17. Gururangan S et al: [18F]Fluorodeoxyglucose-positron emission tomography in patients with medulloblastoma. Neurosurgery. 55(6):1280-9, 2004
                                                                                      18. Koeller KK et al: From the archives of the AFIP: medulloblastoma: a comprehensive review with radiologic-pathologic correlation. Radiographics. 23(6):1613-37, 2003
                                                                                      19. Meyers SP et al: Postoperative evaluation for disseminated medulloblastoma involving the spine: contrast-enhanced MR findings, CSF cytologic analysis, timing of disease occurrence, and patient outcomes. AJNR Am J Neuroradiol. 21(9):1757-65, 2000
                                                                                      20. Tortori-Donati P et al: Medulloblastoma in children: CT and MRI findings. Neuroradiology. 38(4):352-9, 1996