Affiliations: Department of Neurosurgery, Sanjay Gandhi Postgraduate
Institute of Medical Sciences, Lucknow, India
Note: [] Correspondence: Dr. Raj Kumar, Department of Neurosurgery,
Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow – 226014,
U.P., India. Tel.: +91 522 2668700, 2668800 Ext. 2157 (C), 2158 (R), 2107 (OT),
2741 (O); Fax: +91 522 2668129, 2668017; E-mail: rajkumar@sgpgi.ac.in
Abstract: Nine cases of treated medulloblastomas, who developed single or
multiple supratentorial and other neuraxial disseminations at follow-up, were
studied retrospectively regarding their course, route of spread, and outcome.
These cases were encountered over a period of 9 years out of all treated
pediatric medulloblastomas (posterior fossa) between 1999 and July 2005. The
records of all the cases were maintained on a computer database under ICD-9
classification in the hospital records department. All nine cases developed
frontal or subfrontal metastases, while two developed small recurrences in the
posterior fossa. Two of nine cases developed multiple spread within the
neuraxis. Surgical excision of frontal metastases was performed in two cases
and chemotherapy was offered in seven cases. The following inferences were
drawn from this analysis. (i) Supratentorial or any neuraxial dissemination may
occur as early as 6~months or may be delayed for up to 9.5 years. (ii)
Dissemination of disease may not be associated with recurrence at the primary
site in most of the cases. (iii) Even chemotherapy may not be promising in all
the cases, but it may prolong survival in some cases, if it is tolerated well.
(iv) Surgical excision of metastasis may have risk of further dissemination of
disease.
