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Vol. 46, No. 5, 2010
Issue release date: April 2011
Pediatr Neurosurg 2010;46:381–384

Medulloblastoma with Extensive Nodularity Undergoing Post-Therapeutic Maturation to a Gangliocytoma: A Case Report and Literature Review

Chelliah D. · Mensah Sarfo-Poku C. · Stea B.D. · Gardetto J. · Zumwalt J.
aSchool of Medicine and bSchool of Public Health, Loma Linda University, Loma Linda, Calif., and Departments of cRadiation Oncology and dPathology, University of Arizona, Tuscon, Ariz., USA

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We present a report of a 12-year-old boy diagnosed with medulloblastoma at 22 months of age. A gross total resection was performed followed by adjuvant systemic chemotherapy due to his young age; however, the tumor recurred locally in the posterior fossa 7 months later. The recurrent tumor was excised and he received craniospinal radiation with a boost given to the posterior fossa followed by high-dose chemotherapy. He remained disease free for approximately 10 years without major neurologic deficit and only mild cognitive impairment. A routine follow-up MRI of the brain revealed an enhancing mass. The patient underwent surgical debulking and pathological examination revealed no residual immature medulloblastoma cells but instead mature ganglion cells, consistent with a gangliocytoma. The apparent maturation of primitive medulloblastoma cells is a rare phenomenon, which may have ensued from the long-term effects of adjuvant therapies inducing advanced cellular maturation.

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