Medulloblastomas of the Cerebellum in Children: Clinicopathologic Comparison

Authors

  • V. V. Morgun Institute of neurosurgery named after A. P. Romodanov of the NAMS of Ukraine,
  • О. G. Chernenko Institute of neurosurgery named after A. P. Romodanov of the NAMS of Ukraine,
  • I. A. Malovichko Zaporizhzhia State Medical University,
  • S. O. Rudenko P. L. Shupyk National Medical Academy of Postgraduate Education,
  • Т. A. Malysheva Institute of neurosurgery named after A. P. Romodanov of the NAMS of Ukraine,
  • V. P. Sil’chenko P. L. Shupyk National Medical Academy of Postgraduate Education,
  • L. M. Verbova Institute of neurosurgery named after A. P. Romodanov of the NAMS of Ukraine,

DOI:

https://doi.org/10.14739/2310-1237.2017.1.97171

Keywords:

brain, medulloblastoma, neoplasms

Abstract

Embryonal neuroepithelial tumours of the brain, grade IV are mainly observed in children and are characterized by rapid metastatic spread and frequent recurrence.

The aim of the work is to compare structural features of medulloblastomas of the cerebellum in children of different age groups taking into account localization, metastatic spread and treatment outcomes.

Materials and methods. The results of complete examination and surgical treatment of 289 children with medulloblastoma of the cerebellum at the Department of Pediatric Neurosurgery of Institute of neurosurgery named after A.P. Romodanov over the period of 1993–2013 were analysed. The children’s age ranged from 1 month to 17 years: peak of medulloblastoma detection was registered at the age of 4–7.

Results. As part of the study all the patients were divided into four age groups. Younger children rarely had brainstem lesion. In children of older age brainstem lesion, invasion into cerebral aqueduct with the development of noncommunicating hydrocephalus were registered. Total resection of medulloblastoma in younger children was performed in 40 % of cases, subtotal – in 42 %, partial – in 18 %. In children of older age total resection of medulloblastoma was carried out in 36%, subtotal – in 52 %, partial – in 12 % of cases. Histological analysis of tumours involved morphological characteristics of general histoarchitecture, correlation between parenchymal and stromal component, presence of Homer Wright pseudorosettes, collonar structures, pale insulas, true ependymal rosettes, formation of braided collonar structures, prevalence of small low-differentiated structures, number of mitoses, neoangiogenesis and angioproliferation, presence of colliquative and coagulation necroses, evidence and type of invasion, lymphocytic infiltration of tumour tissue. The following variations were defined histologically: classical – 9470/3 in 34 cases (17.9 %), desmoplastic/nodular – 9471/3 in 17 cases (8.9 %), with extensive  nodularity – 9471/3 in 59 cases (31.2 %), large-cell (anaplastic) – 9474/3 in 51 cases (26.9 %), does not belong to any of the above (transitional/combined) – 9470/3 in 28 cases (15.1 %).

Conclusions. It was established that survival index after total and subtotal tumour resection was not significantly different; a negative prognostic factor was only a partial removal of the tumour. 

References

Louis, D. N., Perry, A., Reifenberger, G., von Deimling, A., Figarella-Branger, D., Cavenee, W. K., et al. (2016) The 2016 WHO Classification of Tumours of the Central Nervous System. ActaNeuropathol, 131(6), 803–820. doi:10.1007/s00401-016-1545-1.

Kumirova, E. V. (2010). Eʹmbrionalʹnye opukholi centralnoj nervnoj sistemy u detej: optimizaciya lecheniya i resulʹtaty (Avtoref. dis. doc. med. nauk). [Embryonic tumors of the central nervous system in children: optimization of treatment and results Dr. med. sci. diss.]. Moscow [in Russian].

Orlov, Y., Shaversky, A., Morgun, V. & Marushchenko, L. (2015). Medulloblastomy mozzhechka u detej (vozrastnoj aspect) [Cerebellar medulloblastomas in children (age-related aspect)]. Ukrainskij nejrohirurgicheskij zhurnal, 3, 50–53. [in Russian].

Solovev, A. E., Morgun, V. V., Malovichko, I. A., & Pakholchuk, A. P. (2015). Medulloblastomy u detej. [Medulloblastomas in children]. Onkopediatrija, 2, 158–161. [in Russian].

Shavers’kyi, A. V., Orlov, Yu. A., Mykhaliuk, V. S., Svyst, A. A., Plavs’kyi, P. N., Ziabchenko, V. I., et al. (2013) Diagnostika i lecheniye medulloblastom mozzhechka u detej [Diagnostics and treatment of medulloblastoma of cerebellum in children]. Zbirnyk naukovykh prats spivrobitnykiv NMAPO im. P. L. Shupyka, 22(3), 34–41. [in Russian].

Macko, D. E. & Korshunov, A. G. (1998). Atlas opukholej centralnoj nervnoj sistemy [Atlas of tumors of the central nervous system]. Saint Petersburg [in Russian]

Louis, D. N., Ohgaki, H., Wiestler, O. D., Cavenee, W. K., Burger, P. C., Jouvet, A., et al. (2007) The 2007 WHO Classification of Tumours of the Central Nervous System. ActaNeuropathol, 114(2), 97–109. doi: 10.1007/s00401-007-0243-4.

Gerber, N. U., von Hoff, K., Friedrich, C. et al. (2012). Hyperfractionated craniospinal radiochemo therapy followed by maintenance chemotherapy in children older than 4 years with supratentorial central nervous system primitive neuroectodermal tumor (STPNET) and pineoblastoma. Abstracts from the 15th International Symposium on Pediatric Neuro-Oncology, 14(1), MB-52. doi:10.1093/neuonc/nos093.

Shaverskyi, A. V. (2014). Pukhlyny holovnoho mozku u ditei molodshoho viku (Avtoref. dis… dokt. med. nauk) [Brain tumors in young children Dr. med. sci. diss.]. Kyiv. [in Ukrainian].

Johnston, D. L., Keene, D. L., Lafay-Cousin, L., Steinbok, P., Sung, L., Carret, A. S., et al. (2007). Supratentorial primitive neuroectodermal tumors: a Canadian pediatric brain tumor consortium report. J Neurooncol, 86(1), 101–108. doi: 10.1007/s11060-007-9440-1.

Chan, M. Y., Teo, W. Y., Seow, W. T., & Tan, A. M. (2007). Epidemiology management and treatment outcome of medulloblastoma Singapore. Ann Acad Med Singapore, 36(5), 314–318.

Rutkowski, S. (2008). Chemotherapeutic strategies for young children with brain tumors. SIOP Abstract Book, 40th Congress of the SIOP. Berlin.

Downloads

How to Cite

1.
Morgun VV, Chernenko ОG, Malovichko IA, Rudenko SO, Malysheva ТA, Sil’chenko VP, Verbova LM. Medulloblastomas of the Cerebellum in Children: Clinicopathologic Comparison. Pathologia [Internet]. 2017Apr.7 [cited 2024Dec.24];(1). Available from: http://pat.zsmu.edu.ua/article/view/97171

Issue

No. 1 (2017)

Section

Original research

License

Authors who publish with this journal agree to the following terms:

    1. Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
Лицензия Creative Commons
    1. Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.

  1. Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (SeeThe Effect of Open Access).