E- POSTER

SUPRATENTORIAL AND SPINE METASTATIC

MEDULLOBLASTOMA IN ADULTS: A CASE REPORT
M.S Ranuwibawa. N.G Wahyudana
Tabanan Hospital Bali

BACKGROUND: Medulloblastoma is an infratentorial primitive

neuroectodermal tumor that accounts for approximately 1.5% of all
intracranial tumors. The incidence of medulloblastoma varies between 20-
35% in children. The disease is rare in adults, affecting patients aged between
30 and 50 years of age, with an incidence of 0.5 cases per 1,000,000
individuals.

CASE: A twenty four-year-old man with a chief complaint of weakness of the

lower extremity. Physical examinations reveal myelopathy sign at XII Thoracic
level. Past medical history reveals that he had underwent total resection of a
medulloblastoma of the cerebellum three years before prior to the weakness.
The patient undergoes thoracolumbar MRI with gadolinium contrast injection
and a solid mass at thoracic vertebra 12 lumbar 1. Four months after the
total resection of the spinal mass, the patient presented again, however with a
chief complaint of vomiting and a severe headache. A head CT Scan was
done followed by a head MRI with gadolinium contrast injection. A mass was
found at the right temporoparietal region and craniotomy for tumor removal
was immediately done to resolve the intra cranial pressure problem.
Pathological anatomy revealed the spinal and intracranial mass as
medulloblastoma. After 3 months since the total resection of the cranial mass,
he returned again with chief complaints of low back pain and exertions of pain
during walking. We suggest doing MRI of Thoracolumbar region with
gadolinium contrast injection. The result of the MRI revealed multiple nodules
at the Lumbar vertebrae levels 1, 3, and 5, extending to the level of the
sacrum. Until now, we suggest the patient to do laminectomy to evacuate the
mass, but he and his family are still in discussion for further treatment.

CONCLUSION: An adult with primary medulloblastoma of the cerebellum

presented with metastases of the spine and supratentorial regions. However
incidences of medulloblastoma are very rare in adults, compared to metastatic
medulloblastoma cases in children.