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Pediatrics
Diagnosis
Brain
Cysts and Neoplasms
Medulloblastoma
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 is histologically similar to PNET but biologically distinct
                  • MB is distinguished from PNET by i17q, loss of 17p, alterations of SHH & Wnt pathways, pattern of DNA methylation

              • Definitions

                • Malignant (WHO grade 4), invasive, highly cellular embryonal tumor

              IMAGING

              • General Features

                • CT Findings

                  • MR 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. Zhang M et al: Radiomic phenotypes distinguish atypical teratoid/rhabdoid tumors from medulloblastoma. AJNR Am J Neuroradiol. 42(9):1702-8, 2021
                                          2. Dasgupta A et al: Nomograms based on preoperative multiparametric magnetic resonance imaging for prediction of molecular subgrouping in medulloblastoma: results from a radiogenomics study of 111 patients. Neuro Oncol. 21(1):115-24, 2019
                                          3. Iv M et al: MR imaging-based radiomic signatures of distinct molecular subgroups of medulloblastoma. AJNR Am J Neuroradiol. 40(1):154-61, 2019
                                          4. Aboian MS et al: Early detection of recurrent medulloblastoma: the critical role of diffusion-weighted imaging. Neurooncol Pract. 5(4):234-40, 2018
                                          5. Shih RY et al: Embryonal tumors of the central nervous system: from the radiologic pathology archives. Radiographics. 38(2):525-41, 2018
                                          6. Chua FHZ et al: Post-operative diffusion weighted imaging as a predictor of posterior fossa syndrome permanence in paediatric medulloblastoma. Childs Nerv Syst. 33(3):457-65, 2017
                                          7. Patay Z et al: MR imaging characteristics of wingless-type-subgroup pediatric medulloblastoma. AJNR Am J Neuroradiol. 36(12):2386-93, 2015
                                          8. Raybaud C et al: Posterior fossa tumors in children: developmental anatomy and diagnostic imaging. Childs Nerv Syst. 31(10):1661-76, 2015
                                          9. Wong TT et al: Factors affecting survival of medulloblastoma in children: the changing concept of management. Childs Nerv Syst. 31(10):1687-98, 2015
                                          10. 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
                                          11. Perreault S et al: MRI surrogates for molecular subgroups of medulloblastoma. AJNR Am J Neuroradiol. 35(7):1263-9, 2014
                                          12. 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
                                          13. Pierce T et al: Use of apparent diffusion coefficient values for diagnosis of pediatric posterior fossa tumors. Neuroradiol J. 27(2):233-44, 2014
                                          14. 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
                                          15. Yeom KW et al: Distinctive MRI features of pediatric medulloblastoma subtypes. AJR Am J Roentgenol. 200(4):895-903, 2013
                                          16. Poretti A et al: Neuroimaging of pediatric posterior fossa tumors including review of the literature. J Magn Reson Imaging. 35(1):32-47, 2012
                                          17. Eran A et al: Medulloblastoma: atypical CT and MRI findings in children. Pediatr Radiol. 40(7):1254-62, 2010
                                          18. 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
                                          19. Louis DN et al: The 2007 WHO classification of tumours of the central nervous system. Acta Neuropathol. 114(2):97-109, 2007
                                          20. Gururangan S et al: [18F]fluorodeoxyglucose-positron emission tomography in patients with medulloblastoma. Neurosurgery. 55(6):1280-9, 2004
                                          21. Koeller KK et al: From the archives of the AFIP: medulloblastoma: a comprehensive review with radiologic-pathologic correlation. Radiographics. 23(6):1613-37, 2003
                                          22. 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 is histologically similar to PNET but biologically distinct
                                                          • MB is distinguished from PNET by i17q, loss of 17p, alterations of SHH & Wnt pathways, pattern of DNA methylation

                                                      • Definitions

                                                        • Malignant (WHO grade 4), invasive, highly cellular embryonal tumor

                                                      IMAGING

                                                      • General Features

                                                        • CT Findings

                                                          • MR 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. Zhang M et al: Radiomic phenotypes distinguish atypical teratoid/rhabdoid tumors from medulloblastoma. AJNR Am J Neuroradiol. 42(9):1702-8, 2021
                                                                                  2. Dasgupta A et al: Nomograms based on preoperative multiparametric magnetic resonance imaging for prediction of molecular subgrouping in medulloblastoma: results from a radiogenomics study of 111 patients. Neuro Oncol. 21(1):115-24, 2019
                                                                                  3. Iv M et al: MR imaging-based radiomic signatures of distinct molecular subgroups of medulloblastoma. AJNR Am J Neuroradiol. 40(1):154-61, 2019
                                                                                  4. Aboian MS et al: Early detection of recurrent medulloblastoma: the critical role of diffusion-weighted imaging. Neurooncol Pract. 5(4):234-40, 2018
                                                                                  5. Shih RY et al: Embryonal tumors of the central nervous system: from the radiologic pathology archives. Radiographics. 38(2):525-41, 2018
                                                                                  6. Chua FHZ et al: Post-operative diffusion weighted imaging as a predictor of posterior fossa syndrome permanence in paediatric medulloblastoma. Childs Nerv Syst. 33(3):457-65, 2017
                                                                                  7. Patay Z et al: MR imaging characteristics of wingless-type-subgroup pediatric medulloblastoma. AJNR Am J Neuroradiol. 36(12):2386-93, 2015
                                                                                  8. Raybaud C et al: Posterior fossa tumors in children: developmental anatomy and diagnostic imaging. Childs Nerv Syst. 31(10):1661-76, 2015
                                                                                  9. Wong TT et al: Factors affecting survival of medulloblastoma in children: the changing concept of management. Childs Nerv Syst. 31(10):1687-98, 2015
                                                                                  10. 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
                                                                                  11. Perreault S et al: MRI surrogates for molecular subgroups of medulloblastoma. AJNR Am J Neuroradiol. 35(7):1263-9, 2014
                                                                                  12. 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
                                                                                  13. Pierce T et al: Use of apparent diffusion coefficient values for diagnosis of pediatric posterior fossa tumors. Neuroradiol J. 27(2):233-44, 2014
                                                                                  14. 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
                                                                                  15. Yeom KW et al: Distinctive MRI features of pediatric medulloblastoma subtypes. AJR Am J Roentgenol. 200(4):895-903, 2013
                                                                                  16. Poretti A et al: Neuroimaging of pediatric posterior fossa tumors including review of the literature. J Magn Reson Imaging. 35(1):32-47, 2012
                                                                                  17. Eran A et al: Medulloblastoma: atypical CT and MRI findings in children. Pediatr Radiol. 40(7):1254-62, 2010
                                                                                  18. 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
                                                                                  19. Louis DN et al: The 2007 WHO classification of tumours of the central nervous system. Acta Neuropathol. 114(2):97-109, 2007
                                                                                  20. Gururangan S et al: [18F]fluorodeoxyglucose-positron emission tomography in patients with medulloblastoma. Neurosurgery. 55(6):1280-9, 2004
                                                                                  21. Koeller KK et al: From the archives of the AFIP: medulloblastoma: a comprehensive review with radiologic-pathologic correlation. Radiographics. 23(6):1613-37, 2003
                                                                                  22. Tortori-Donati P et al: Medulloblastoma in children: CT and MRI findings. Neuroradiology. 38(4):352-9, 1996