Ghose Abhimanyu, Morris John C, Breneman John C, Essell James, Wang Jiang, Benzaquen Sadia
University of Cincinnati, Cincinnati, OH, USA.
Oncology Hematology Care Inc, Cincinnati, OH, USA.
J Investig Med High Impact Case Rep. 2014 Apr 17;2(2):2324709614532798. doi: 10.1177/2324709614532798. eCollection 2014 Apr-Jun.
Background. Medulloblastoma, although the most common brain tumor of childhood, is exceedingly rare in adults. These tumors have a propensity for local recurrence and to metastasize along the leptomeninges; however, extraneural metastases are very rare and typically occur in the bone or bone marrow. We have not come across any case in literature of medulloblastoma with mediastinal metastases in an adult. Case Presentation. We report a case of medulloblastoma in a 38-year-old lady who was treated with surgery followed by craniospinal radiation. Ten years later she presented with hoarseness from true vocal cord paralysis. She was diagnosed to have infiltrating metastases of her medulloblastoma to the mediastinum, which was confirmed by biopsy. There was no local recurrence. This was treated with chemotherapy followed by stem cell rescue, and she remained progression free for 2 years. Conclusion. Medulloblastomas are rare in adults and can present with late extraneural metastases following treatment. Although most common reported sites are bone and bone marrow, late metastases to other unexpected areas like the mediastinum are possible too and warrant awareness. This can be treated with chemotherapy followed by high-dose chemotherapy and stem cell rescue in a young patient with good performance status.
背景。髓母细胞瘤虽是儿童期最常见的脑肿瘤，但在成人中极为罕见。这些肿瘤易于局部复发并沿软脑膜转移；然而，神经外转移非常罕见，通常发生在骨骼或骨髓。我们在文献中未见过成人髓母细胞瘤发生纵隔转移的病例。病例报告。我们报告一例38岁女性髓母细胞瘤患者，接受了手术治疗，随后进行了全脑全脊髓放疗。十年后，她因真性声带麻痹出现声音嘶哑。经活检确诊为髓母细胞瘤浸润转移至纵隔，无局部复发。给予化疗，随后进行干细胞救援，她无进展生存了2年。结论。髓母细胞瘤在成人中罕见，治疗后可出现晚期神经外转移。虽然最常见的转移部位是骨骼和骨髓，但晚期转移至纵隔等其他意外部位也是可能的，需要引起重视。对于身体状况良好的年轻患者，可采用化疗，随后进行大剂量化疗和干细胞救援进行治疗。
