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Abstract

Magnetic resonance imaging (MRI) is the radiologic modality of choice used to evaluate suspected lesions in the posterior fossa, given its greater sensitivity compared with other neuroimaging techniques. The case of a 9-year-old girl with progressive ataxia is presented. MRI of the brain demonstrated nonspecific T₂ -weighted abnormalities involving the cerebellar vermis with minimal mass effect suggested by asymmetric enlargement of the left superior cerebellar peduncle. Postgadolinium studies showed only minimal enhancement of the left superior cerebellar peduncle. After an MRI of the spine demonstrated drop metastases, a cerebellar biopsy was performed, which revealed an infiltrating medulloblastoma confined to the granular layer and leptomeninges. Hence, MRI is an important ancillary tool in the diagnosis of medulloblastoma, but caution needs to be taken when interpreting imaging studies. (J Child Neurol 2003; 18: 64—67).

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References

Gusnard DA : Cerebellar neoplasms in children. Semin Roentgenol 1990;25:263—278.

Arseni C. , Ciurza AV : Statistical survey of 276 cases of medulloblastomas (1935—1978). Acta Neurochir 1982;57:159—162.

Packer RJ , Siegel KR , Sutton LN , et al: Efficacy of adjuvant chemotherapy for patients with poor-risk medulloblastoma: A preliminary report. Ann Neurol 1988; 24: 503—508.

Barkovitch AJ : Pediatric Neuroimaging, 3rd ed. Philadelphia, Lippincott, Williams & Wilkins, 2000.

Friedman HS , Oakes WJ , Bigner SH , et al: Medulloblastoma: Tumor biological and clinical perspectives . J Neurooncol 1991; 11: 1—15.

Koci TM , Chiang F. , Mehringer CM , et al: Adult cerebellar medulloblastoma: Imaging features with emphasis on MR. AJNR Am J Neuroradiol 1993; 14: 929—939.

Sandhu A. , Kendall B. : Computed tomography in management of medulloblastomas. Neuroradiology 1987;29:444—452.

Graham DI , Lantos PL : Greenfield's Neuropathology, 7th ed. London, Arnold, 2002.

Blaser SI , Harwood-Nash DC : Neuroradiology of pediatric posterior fossa medulloblastoma. J Neurooncol 1996; 29: 23—34.

10.

Zee CS , Segall HD , Nelson M. , et al: Infratentorial tumors in children. Neuroimaging Clin North Am 1993;3:705—714.

11.

George RE , Laurent JP , McCluggage CW , Cheek WR : Spinal metastasis in primitive neuroectodermal tumors (medulloblastoma) of the posterior fossa: Evaluation with CT myelography and correlation with patient age and tumor differentiation. Pediatr Neurosci 1985—1986;12: 157—160.

12.

Gould VE , Rorke LB , Jansson DS , et al: Primitive neuroectodermal tumors of the central nervous system express neuroendocrine markers and may express all classes of intermediate filaments. Hum Pathol 1990;21:245—252.

13.

Wiedenmann B. , Franke WW : Identification and localization of synaptophysin, an integral membrane glycoprotein of Mr 38,000 characteristic of presynaptic vesicles. Cell 1985;41:1017—1028.

14.

Janss AJ , Yachnis AT , Silber JH , et al. Glial differentiation predicts poor clinical outcome in primitive neuroectodermal brain tumors. Ann Neurol 1996 ; 39: 481—489.

15.

Brant-Zawadzki M. , Badami JP , Mills CM , et al: Primary intracranial tumor imaging: A comparison of magnetic resonance and CT. Radiology 1984;150:435—440.

16.

Meyers SP , Kemp SS , Tarr RW : MR imaging features of medulloblastomas. AJR Am J Roentgenol 1992; 158: 859—865.

17.

Bourgouin PM , Tampieri D. , Grahovac SZ , et al: CT and MR imaging findings in adults with cerebellar medulloblastoma: Comparison with findings in children. AJR Am J Roentgenol 1992; 159: 609—612.

18.

Osborn AG : Diagnostic Neuroradiology, 2nd ed. St. Louis, Mosby, 1996.

Atypical Features of Medulloblastoma on Magnetic Resonance Imaging

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