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Helen Toledano, Mika Rootman, Shalom Michowiz, Osnat Konen, MBCL-12. METASTATIC DISEASE IN THE SUPRASELLAR AREA AT DIAGNOSIS IN MEDULLOBLASTOMA, Neuro-Oncology, Volume 20, Issue suppl_2, June 2018, Page i119, https://doi.org/10.1093/neuonc/noy059.410
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Abstract
Metastatic disease at presentation of medulloblastoma is present in approximately 30% and confers a poor prognosis. Metastases are usually spinal and occult intracranial metastases maybe overlooked. The infundibular recess of the third ventricle is a known site of metastases in various tumors particularly at relapse. The diagnostic brain and spinal imaging of all our medulloblastoma patients from 1/2007 to 12/2017 were assessed by 2 radiologists blinded to patient outcome. We collected clinical data retrospectively from the charts.
Of 69 children with medulloblastoma over 11 years, 6 (8.7%) were found to have metastases in this location at presentation (male:female 1:1, mean age 8). In 1 patient the metastasis was biopsied and showed pathology identical to the primary tumor. In 1 patient the metastasis was missed at diagnosis. He was treated on an average risk protocol and subsequently relapsed in the third ventricle. In 2 patients this was a solitary area of metastasis whereas in 4 there was additional extensive spinal disease. In one patient the suprasellar metastasis was symptomatic causing the appearance of the menstrual period at age 8 leading to the diagnostic imaging. None of the others had symptoms referable to their suprasellar metastasis. One patient died due to postoperative complications and 2 died of progressive disease. 3 are still alive (range 9 months - 8 years since diagnosis) including the one who relapsed.
The infundibular recess of the third ventricle is a not uncommon site of metastatsis at diagnosis of medulloblastoma and should be actively assessed.
