DOI: http://dx.doi.org/10.18203/2320-6012.ijrms20195164

A rare case of pediatric medulloblastoma presented with radiographic characteristics of pontine glioma

Kartika ., I. Made Dwijaputra Ayusta, Made Widhi Asih

Abstract


Medulloblastoma is a common malignant brain tumor of childhood which characterized as an infratentorial mass in the roof of the 4th ventricle, causing mass effect and non-communicating hydrocephalus. A 3 years old boy with history of chronic progressive weakness one-month prior admission, followed by difficulty in walking and ataxia. His MRI examination showed an intraaxial well defined mass, partial irregular border, size 4.2x4.0x4.1 cm at pons, hypointense in T1W1, hyperintense in T2W1, iso-hypointense in flair, and showing inhomogen contras enhancement after gadolinium administration. It pressed the 4th ventricle without dilatation of other ventricles, suggesting a pontine glioma. Patient underwent surgery to remove mass and the pathological examination revealed small round cells, with differential diagnose of medulloblastoma and anaplastic astrocytoma. This case presented as there was a discrepancy in the clinicoradiological diagnosis with the pathological diagnose of medulloblastoma. The mass was located at the pontine without any sign of hydrocephalus suggested a pontine glioma. Both medulloblastoma and pontine glioma are common for infratentorial mass of pediatric population, but difficult to diagnose due to its heterogeneous presentation. Good comprehension of both radiological characteristics is noteworthy.


Keywords


Medulloblastoma, Magnetic resonance imaging, Pontine glioma, Radiographic

Full Text:

PDF

References


León MM. Review and update about medulloblastoma in children. Radiología. 2011 Jan 1;53(2):134-45.

Collange NZ, Brito SD, Campos RR, Santos EA, Botelho RV. Treatment of medulloblastoma in children and adolescents. Revista da Assoc Médica Brasil. 2016 Jul;62(4):298-302.

Chung EJ, Jeun SS. Extra-axial medulloblastoma in the cerebellar hemisphere. J Kore Neuro Soci. 2014 Jun;55(6):362.

Solanki MK, Ramrakhiani D. Medulloblastoma of the Cerebellopontine angle in a child: a rare entity. Int J Med Res Prf. 216;2(6);124-7.

Bahrami E, Bakhti S, Fereshtehnejad SM, Parvaresh M, Khani MR. Extra-axial medulloblastoma in cerebello-pontine angle: A report of a rare case with literature review. Medi J Isl Rep Iran. 2014;28:57.

Akay KM, Erdogan E, Izci Y, Kaya A. Medulloblastoma of the cerebellopontine angle-case report. Neurol Med Chir. 2003;43(11):555-8.

Taylor MD, Northcott PA, Korshunov A, Remke M, Cho YJ, Clifford SC, et al. Molecular subgroups of medulloblastoma: the current consensus. Acta Neuropathol. 2012;123(4):465-72.

Kumar R, Achari G, Mishra A, Chhabra DK. Medulloblastomas of the cerebellopontine angle. Neurol Ind. 2001;49(4):380-3.