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Atypical interpretation of medulloblastoma

Rabinarayan Panda, Pratosh Paul, Sanjib Mishra, Sudhanshu Sekhar Mishra.

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Introduction: Medulloblastoma is a midline posterior fossa mass that typically develops from the vermis in children. It shows up on a CT scan as a hyperdense, homogeneously enhancing mass and is linked to the clinical profile of posterior fossa syndrome. Although this distinct clinical-radiological pattern is regarded as "typical," medulloblastomas frequently do not follow the normal clinico-radiological pattern.
Methods: To identify the abnormal clinical-radiological features, 28 patients were retrospectively analyzed and 12 cases were prospectively studied. Only 21 of the 40 patients showed the typical radiological feature of a hyperdense homogeneously enhancing mass, while the other four had hypodense nonenhancing masses, 12 had cystic alterations, and five had calcifications in their tumors. Three patients arrived with tumors in the cerebellopontine angle cistern, which is a rather rare position.
Results: Patients who underwent follow-up for a minimum of 6 months and a maximum of 1 year returned with metastases in very odd places. There were 2 patients who had a cervical intramedullary metastasis, and there were 4 occurrences of metastases in the frontal and subfrontal area. One year following final surgery and ventriculoperitoneal shunting, abdominal metastases and ascites occurred in 3 individuals. But after surgery, each of these 3 patients had had a complete course of craniospinal irradiation.
Conclusion: There were other cases that had atypical clinical, radiological, and metastatic patterns.

Key words: Medulloblastoma, Metastasis, Atypical, CT, MRI

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