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Systemic metastases from medullo blastoma 2 cases and review of the literature


, : Systemic metastases from medullo blastoma 2 cases and review of the literature. Cancer 48(10): 2296-2306

The clinical and pathologic data from 2 cases of medulloblastoma with systemic metastases and 101 previously reported cases were evaluated to define better the clinical presentation and natural history. Patients ranged in age from 6 mo. to 48 yr with a mean of 13 yr; two thirds of the patients were male. Ventricular shunts had been inserted in 20% of the patients. Systemic metastases occurred on an average of 2 yr after the diagnosis of the primary tumor in patients without shunts but after only 1.3 yr in patients with shunts. Of the patients, 59% were known to have recurrence or spread of medulloblastoma within the CNS by the time systemic metastases appeared. Ninety percent showed radiologic evidence of bone metastases, of which 60% were osteoblastic, Bones most frequently involved were pelvis, femur and vertebrae; pain was the most common initial symptom. At autopsy lymph nodes metastases were found in 65% and liver metastases were found in 28% of all cases in addition to bone metastases in 82%. Lung metastases occurred in 9% of the patients without shunts, compared with 30% of patients with shunts. The average survival was 7 mo. after the appearance of systemic metastases for patients with and without shunts. Approximately 5% of patients with medulloblastoma may be expected to develop systemic metastases. This development is associated with increased mobidity and a shortened life expectancy.

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