Luo Cha, Zhang Fei, Zhu Xiaofeng, Zeng Ying, Wang Zhonglian, Jiang Hongting, Ye Qing, Jian Wei, Zhang Jing, Fu Qiaofen
Department of Radiation Oncology, The First Affiliated Hospital of Kunming Medical University, 295 Xichang Road, Kunming, Yunnan, China.
Department of Neurosurgery No. 2, The First Affiliated Hospital of Kunming Medical University, 295 Xichang Road, Kunming, 650032, Yunnan, People's Republic of China.
J Cancer Res Clin Oncol. 2025 May 15;151(5):166. doi: 10.1007/s00432-025-06215-9.
Medulloblastoma (MB) is a highly aggressive tumor originating in the cerebellum, predominantly affecting children. Adult medulloblastoma is rare, leading to a lack of a standardized treatment protocol. Although multimodal strategies from pediatric MB have improved outcomes in adult patients, challenges persist, including early diagnosis difficulties, treatment toxicity, recurrence risks, targeted therapies, and controversies over chemotherapy timing and regimen.
We present a clinical case involving a 53-year-old male patient diagnosed with multifocal medulloblastoma, who presented with symptoms of dizziness. Cranial magnetic resonance imaging (MRI) revealed space-occupying lesions in the right cerebellar infratentorial region and the right temporal pole, which were initially suspected to be meningiomas. The patient subsequently underwent surgical resection of the subtentorial lesion, which was pathologically confirmed to be a medulloblastoma. Molecular classification through genetic testing classified it as the SHH subtype. Postoperatively, the patient received sequential radiotherapy and chemotherapy. After radiotherapy, the lesion in the temporal pole disappeared, and the patient recovered well. Disease-free survival of this patient was more than 2 years, during which the patient returned to the hospital for follow-up every three months. Currently, the patient is in good condition with no significant treatment sequelae or signs of recurrence.
Adult medulloblastoma is rare, and adult multifocal medulloblastoma is even rarer. The adult patient with multifocal medulloblastoma we report underwent surgery followed by sequential radiotherapy and chemotherapy, resulting in a favorable prognosis. This may suggest that postoperative radiotherapy combined with chemotherapy could be effective in controlling adult medulloblastoma.
髓母细胞瘤（MB）是一种起源于小脑的高度侵袭性肿瘤，主要影响儿童。成人髓母细胞瘤较为罕见，导致缺乏标准化的治疗方案。尽管来自儿童髓母细胞瘤的多模式治疗策略已改善了成人患者的治疗效果，但挑战依然存在，包括早期诊断困难、治疗毒性、复发风险、靶向治疗以及化疗时机和方案的争议。
我们报告一例临床病例，一名53岁男性患者被诊断为多灶性髓母细胞瘤，表现为头晕症状。头颅磁共振成像（MRI）显示右小脑幕下区域和右颞极有占位性病变，最初怀疑为脑膜瘤。患者随后接受了幕下病变的手术切除，病理证实为髓母细胞瘤。通过基因检测进行的分子分类将其归类为SHH亚型。术后，患者接受了序贯放疗和化疗。放疗后，颞极的病变消失，患者恢复良好。该患者的无病生存期超过2年，在此期间患者每三个月回医院随访一次。目前，患者状况良好，无明显治疗后遗症或复发迹象。
成人髓母细胞瘤罕见，成人多灶性髓母细胞瘤更为罕见。我们报告的患有多灶性髓母细胞瘤的成年患者接受了手术，随后进行序贯放疗和化疗，预后良好。这可能表明术后放疗联合化疗对控制成人髓母细胞瘤可能有效。
