A rare case of desmoplastic medulloblastoma in a 65-year-old male: A case report on achieving stability post-grade IV surgical resection

Abstract

Introduction

Medulloblastoma (MB) is an aggressive cerebellar tumor. In adults, it mainly occurs in the cerebellar hemispheres with desmoplastic traits, constituting 0.4 %–1 % of central nervous system tumors, primarily affecting individuals under 40. Cases above 60 are rare. Recent treatments have improved prognosis, with a 75 %–80 % five-year survival rate.

Case presentation

A 65-year-old man with no medical history presented with intermittent vertigo, progressive headaches, and morning nausea. MRI showed an enhancing desmoplastic medulloblastoma (WHO Grade IV) in the right cerebellar hemisphere. Successful total excision was performed without neurological deficits. Pathology confirmed the diagnosis, followed by chemotherapy and radiotherapy. Postoperative MRI showed complete resection with no spinal metastases. Over four years, the patient remained asymptomatic and stable.

Discussion

Medulloblastoma is rare in adults, presenting with cerebellar dysfunction and elevated intracranial pressure. Imaging and multimodal treatment, including surgery and adjuvant therapy, ensure improved outcomes, as seen in our patient's long-term remission.

Conclusion

This case highlights the importance of considering medulloblastoma in differential diagnoses for older patients with cerebellar symptoms and the success of multimodality treatment.