Medulloblastoma (Child)

Outline of child's head and neck showing cross section of brain.Medulloblastoma is a type of brain cancer. It most often grows in children and young adults.

How a medulloblastoma grows

Medulloblastoma is a primary brain tumor. This means it starts in the brain instead of going to the brain from somewhere else in the body. This type of tumor grows fairly fast. It usually grows in the cerebellum, near the back of the brain. The cerebellum controls balance and coordination. This type of tumor may spread (metastasize) in the brain and spinal cord. A tumor that has spread is harder to treat. Medulloblastoma rarely spreads to other parts of the body. But a tumor in the brain may press against a part of the brain and cause problems.

Types of medulloblastoma

A medulloblastoma can be 1 of these types:

  • Classic. This type of tumor has small, densely packed, round cells.

  • Desmoplastic. This type of tumor has mixed dense and loose areas. It may be easier to treat than classic.

  • Anaplastic. This type of tumor has large, quickly dividing cells. It can be harder to treat than classic.

What causes medulloblastoma?

Researchers are still learning why this kind of brain tumor grows. Certain gene changes may cause the tumor to grow. A small number of people with the tumor have a gene disorder that raises their risk for the tumor. These include Gorlin syndrome and Turcot syndrome. But most people with medulloblastoma do not have a gene disorder.

Symptoms of medulloblastoma

Symptoms may begin slowly and get worse as the tumor grows. Headache is common. A brain tumor may block the normal flow of cerebral spinal fluid (CSF). This leads to increased intracranial pressure (ICP). This may cause headache, nausea, vomiting, and dizziness. Because the tumor grows in the cerebellum, it may affect balance and coordination early on. The symptoms of medulloblastoma may include:

  • Headache, especially in the morning or middle of the night

  • Nausea and vomiting, which may be worst in the morning

  • Changes in ability to think

  • Balance problems or clumsiness

  • Dizziness

  • Double vision or other eye problems

  • Tiredness (fatigue)

Diagnosing medulloblastoma

The health care provider will ask about your child’s health history and symptoms. The provider may also ask about your family’s health history. Your child will be given a physical exam, including a neurologic exam. He or she may be asked to do simple things like walk, touch finger to nose, hold his or her hands out, or follow a light with his or her eyes. If a doctor suspects a brain tumor, your child may need tests such as:

  • MRI of the brain and spinal cord

  • Surgery to remove the tumor and look at the tissue for type and grade of tumor

  • Spinal tap (lumbar puncture) to look for tumor cells in the CSF

Your child may need to see a doctor that deals with brain disorders. This may be a neurologist, neurosurgeon, or neuro-oncologist. The doctor will explain your child’s pathology report. This report tells the size, location, type, grade, and other information about your child’s tumor.

Treatment for medulloblastoma

The health care team will decide the best treatment plan for your child. The plan depends on the type of tumor and where it is. The main treatment may be surgery. This is done to remove as much of the cancer as possible. The tumor is removed and looked at to find out the tumor type and grade. After surgery, your child may have radiation therapy. He or she may also have chemotherapy.

If your child has increased intracranial pressure, he or she may need a shunt. This is a tube put in the head to help drain excess CSF. Your child will need to have follow-up MRI scans done to see how well the treatment is working.

Possible complications of treatment

Some possible complications of treatment include:

  • Temporary brain damage (posterior fossa syndrome) because of surgery that may cause problems with language, emotions, and movement for weeks or years

  • Nausea, vomiting, and tiredness (fatigue) from radiation therapy or chemotherapy

  • Infertility or changes in thinking from radiation therapy

  • A tumor that grows back

Follow-up care

Many people with medulloblastoma have a good outcome. In some cases, the tumor comes back after treatment. To check for this, your child will likely need to have follow-up MRI scans in the weeks after surgery and then a few times a year after that.

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