Medulloblastoma. A report of 201 cases with emphasis on the relationship of histologic variants to survival

Abstract

Medulloblastoma has invariably been associated with a poor prognosis. However, it has been shown that such tumors in adults have a slightly better prognosis than in children. We have studied 201 such neoplasms and attempted to correlate survival with several factors. In our series, adults survived longer (average 50 months) than children (average 11 months), and females (average 31 months) slightly longer than males (21 months). Location of the primary tumor was also of significance since patients with neoplasms primarily located in a cerebellar hemisphere showed a better survival (47 months) than those located in the cerebellar midline (17 months). The histologic typing of the tumor was also important. Patients with “desmoplastic” medulloblastomas had an average survival of 51 months, while those with the “classical” medulloblastomas had an average of 18 months only. The majority of the desmoplastic neoplasms occurred in adults and in cerebellar hemispheres rather than the midline. Further differentiation within the tumor toward the neuroblastic or the glial lines was evident in 51 neoplasms, and no significant differences in survival were noted among them. Four patients eventually developed extracranial metastases, and two were associated with meningiomas.