Salvage Re-irradiation Options in Adult Medulloblastoma: A Case Report and Review of the Literature

In Vivo. 2020 May-Jun;34(3):1283-1288. doi: 10.21873/invivo.11903.

Abstract

Background/aim: Medulloblastoma is a rare tumor of adult age, while it occurs more frequently in children. Given the rarity, there is a lack of evidence for the treatment of recurrent disease. Few data are available about salvage re-irradiation collecting very heterogeneous series.

Case report: A 51-year-old male presented with headache, nausea, double vision, and gait disorders. A contrast-enhanced brain-MRI showed the presence of multifocal medulloblastoma. After surgery, adjuvant craniospinal radiotherapy was performed, chemotherapy was stopped due to toxicity. After 27 months, a new MRI and a Methionine-PET revealed a late pontocerebellar relapse; multidisciplinary board decided for a SBRT treatment. The second course of RT was well tolerated and 14 months later, the patient is alive in good general conditions, with no evidence of disease.

Conclusion: Our experience supports the use of salvage stereotactic radiotherapy as a safe and effective treatment option.

Keywords: Medulloblastoma; adult patients; re-irradiation.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Cerebellar Neoplasms / diagnosis
  • Cerebellar Neoplasms / radiotherapy*
  • Humans
  • Magnetic Resonance Imaging
  • Male
  • Medulloblastoma / diagnosis
  • Medulloblastoma / radiotherapy*
  • Middle Aged
  • Positron-Emission Tomography
  • Re-Irradiation*
  • Salvage Therapy
  • Treatment Outcome
  • Tumor Burden