Extraneural metastatic medulloblastoma in an adult.

Medulloblastoma is a rare malignancy in adults, accounting for approximately 1% of all primary brain tumors. Extraneural metastases have been reported in 10-30% of cases and most commonly involve bone; rarely lymph nodes, visceral organs and bone marrow may be involved with disease. We report here our experience with a 26 year-old woman with medulloblastoma treated with gross total resection followed by radiation therapy to her craniospinal axis. She subsequently developed widespread metastatic disease involving bone exclusive of the calvarium and spine for which multi-agent salvage chemotherapy was utilized with initial good clinical response. She later relapsed within the lymph nodes and soft tissues of the pelvis and eventually suffered a local recurrence within the posterior fossa. The treatment of medulloblastoma, particularly salvage therapy following disease recurrence, is reviewed.