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Medulloblastoma

(Primitive Neuroectodermal Tumor)

Definition

Medulloblastoma is a type of harmful brain tumor. It starts in the cerebellum, at the bottom and back of the brain.

The cerebellum is the center for balance, coordination, and movement. Over time, the tumor can cause problems with these functions. This tumor can also block the flow of cerebrospinal fluid (CSF). CSF surrounds and protects the brain and spinal cord. Blocked flow can cause a buildup of pressure in the brain.

Cerebellum and Brain Stem
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Causes

Cancer is when cells in the body split without control or order. These cells go on to form a growth or tumor. The term cancer refers to harmful growths. These growths attack nearby tissues. They also spread throughout the brain or spinal cord. It's not clear exactly what causes these problems. It’s likely a mix of genes and the environment.

Risk Factors

A medulloblastoma can happen at any age. But, it’s more common in children and males.

Symptoms

Symptoms may not be noticed at first. Over time, they will appear and worsen.

A medulloblastoma may cause:

  • Nausea or vomiting
  • Headaches, mainly in the morning
  • Lack of coordination in the upper part of the body
  • Vision problems such as double vision or inability to look up with the eyes
  • Changes in hunger
  • Changes in behavior
  • Stumbling
  • Falling
  • Fatigue
  • Seizures

Diagnosis

The doctor will ask about your symptoms and health history. Your answers and a physical exam may point to a medulloblastoma. You may also have:

Treatment

Treatment depends on the stage and type of cancer. The goals are to:

  • Remove as much of the tumor as possible to:
    • Ease problems caused by pressure on nearby structures
    • Restore the flow of CFS
  • Cure the cancer and keep it from coming back

Surgery

A small hole in the skull is opened to remove the tumor. It may be a part of it or all of it.

If there is a problem with the flow of CSF, you may need:

  • A ventriculoperitoneal (VP) shunt —Plastic tubes ease CSF fluid buildup in the brain. It flows to the chest or belly.
  • Endoscopic third ventriculostomy—A small hole is made below the brain that lets CSF flow.
  • External ventricular drain (EVD)—A plastic tube runs from the brain to a bag outside of the body. CSF drains into the bag.

Radiation Therapy

Radiation therapy is the use of radiation to kill cancer cells and shrink tumors. It may be used after surgery to kill any remaining cancer cells.

A special type is used on the entire brain and spinal cord.

Chemotherapy

Chemotherapy is the use of drugs to kill cancer cells. It may given by mouth, shots, or IV. The drugs enter the bloodstream and travel throughout the body.

Chemotherapy may be used to support other treatments.

Medications

Targeted therapy uses medicines to block the growth of tumors. One way is to block the growth of new blood vessels the tumor needs to grow.

Prevention

There is no way to prevent a medulloblastoma since the cause is unknown.

RESOURCES:

American Brain Tumor Association
https://www.abta.org

American Cancer Society
https://www.cancer.org

CANADIAN RESOURCES:

Brain Tumour Foundation of Canada
https://www.braintumour.ca

Canadian Cancer Society
https://www.cancer.ca

REFERENCES:

Brain and nervous system cancers. Kids Health—Nemours Foundation website. Available at: http://kidshealth.org/en/parents/brain-tumors.html. Accessed January 29, 2021.

Brain and spinal cord tumors in adults. American Cancer Society website. Available at: https://www.cancer.org/cancer/brain-spinal-cord-tumors-adults.html. Accessed January 29, 2021.

Brain and spinal cord tumors in children. American Cancer Society website. Available at: https://www.cancer.org/cancer/brain-spinal-cord-tumors-children.html. Accessed January 29, 2021.

Medulloblastoma in children. Boston Children’s Hospital website. Available at: http://www.childrenshospital.org/conditions-and-treatments/conditions/m/medulloblastoma. Accessed January 29, 2021.

Last reviewed September 2020 by EBSCO Medical Review Board Mohei Abouzied, MD, FACP