Management of Medulloblastoma Metastases: Algerian Experience

Abstract

This work is based on the study of patients treated for medulloblastoma metastasis at diagnosis between January 2006 and December 2015 in the neurosurgery department of the Ait IDDIR Health Hospital Establishment. Our series consisted of 16 patients, 11 men and 5 women; the median age was 16.9 years. The baseline, presentation of symptoms and signs, imaging results (MRI), surgical results and clinical results were recorded. The clinical manifestation was revealed by intracranial hypertension syndrome (100%), associated with cerebellar syndrome (80%). The localization was in Intra-nevraxics: (81.25%) and in Extra-nevraxics (18.75%). 68.75% of patients underwent total surgical excision and 31.25% underwent subtotal surgical excision. The presence of malignant cells in the CSF is marked in 56.25%. The pathological study revealed that 62.5% of cases had a classic variant and 37.5% a desmoplastic variant. 30% of the cases were classified as “standard risk” and 70% as “high risk”. The surgery was supplemented by radiotherapy of the entire neuraxis using the “movable junctions” technique in all cases. The average delay was 70 days. Adjuvant chemotherapy was performed in 9 cases. The long-term survival rate after metastasis varies between 06 months to 24 months, only 04 cases (25%) are still alive. The management of medulloblastoma must be multidisciplinary involving neurosurgeons and radiotherapist oncologists. This collaboration is the only guarantee of an improvement in his prognosis