Medulloblastoma – causes, complaints & therapy

The malignant tumor, which according to the WHO has grade IV, occurs predominantly in childhood. Due to the location of the tumor, it is possible that it can drain the cancer cells into the cerebrospinal fluid. Thus, secondary tumors or metastases can occur. Medulloblastoma is considered the most common brain tumor that can occur in children. As a rule, the tumor forms before the age of 15. Statistically, boys are affected more often than girls.

Causes

The development of medulloblastoma is primarily due to the fact that immature embryonic cells degenerate. Why these cells degenerate, however, is still unclear. As a rule, medulloblastoma forms spontaneously. Thus, there is no indication that indicates inheritance. However, there are genetic changes that may be associated with medulloblastoma. Medulloblastoma occurs predominantly when certain chromosomes are present in the cells. Why this genetic modification occurs, however, is also unknown.

Symptoms and course

Typical symptoms of medulloblastoma:

• Headache

• Nausea

• Vomit

• Paralysis

• Sensory disturbances

• Numbness

• Movement disorders

Predominantly, the patient complains of headaches and nausea. Other symptoms may include vomiting, strabismus, dizziness or paralysis. With involvement of the brainstem, the patient may also have sensory disturbances (classic for this is the numbness) or have problems with the coordination of his movements.

It is also possible that there is a drainage disorder or disturbance of the circulation of the cerebrospinal fluid (cerebrospinal fluid) if the tumor is relatively large. Thus, a so-called water head can arise. Since cells repeatedly detach from the medulloblastoma, which are then transported via the cerebrospinal fluid, the formation of secondary ulcers is possible. These secondary ulcers can occur, among other things, on the spinal cord as well as in the meninges.

The earlier the diagnosis is made or the therapy takes place, the higher the patient’s chances of recovery. Predominantly the chances of recovery are good if no secondary ulcers have yet formed. The tumor is recurrent, so a return after successful treatment – within the first few years – is possible. For this reason, regular checks or follow-up examinations are urgently required.

Diagnosis

The physician makes the diagnosis on the basis of the imaging procedures. This means that if there is a sign of medulloblastoma, magnetic resonance imaging – MRI for short – is ordered. Here, the physician can see whether it is a medulloblastoma or where it is positioned. It is also possible that the doctor recognizes what size the tumor has already reached.

Furthermore, the MRI scan is also suitable because the doctor can see whether tumor cells have already entered the liquor. However, to be sure, the medic will also need to do a spinal Tap. Finally, the sample of the cerebrospinal fluid can provide better information as to whether cancer cells are present in the cerebrospinal fluid or not. The tumor cells in the liquor are often not visible on the MRI images.

treatment and therapy

Even if the medulloblastoma is a malignant tumor, the treatment is extremely promising. About 50 to 70 percent of those affected can be completely cured. It is crucial when the tumor was discovered or when the treatment is started. The medulloblastoma is treated surgically using microsurgical and laser surgical procedures, with complete removal being the top priority. After the operation, Radiation Therapy is prescribed. This is because medulloblastomas are very sensitive to radiation.

In children who are not yet four years old, chemotherapy is often prescribed instead of radiotherapy . The affected person receives cytostatic drugs, which are primarily intended to prevent the growth of cancer cells. The problem, however, is that these drugs also attack healthy cells. Patients can complain of severe nausea, hair loss and vomiting. In a few cases, it is not possible for the medulloblastoma to be completely surgically removed. The physician must therefore shrink the tumor using radiotherapy and chemotherapy and try to remove it completely in a second operation.It can also happen that the medulloblastoma blocks the cerebrospinal fluid or clogs its drainage. In order for this congestion to be eliminated, the doctor must create a so-called tube system so that the liquid can be drained off. This derivation occurs through an external drainage. The tumor is recurrent – this means that there is a high probability that it will come back after therapy. For this reason, it is important that regular follow-up checks are observed. If the medulloblastoma returns, radiation and chemotherapy are prescribed again or the cancerous tissue is surgically removed.

Prevention

Prevention is currently unknown. However, carcinogenic chemicals and other pollutants can promote the formation of medulloblastoma. A healthy diet and regular exercise – even in childhood – should be part of everyday life.