Medulloblastoma | Diagnosis & Treatment

Your child’s physician may order a number of different tests to determine the type and location of the tumor. In addition to a physical exam, medical history, and neurological exam, diagnostic procedures for medulloblastoma may include:

If your child has medulloblastoma, your child’s physician also will perform a lumbar puncture, or spinal tap. However, this will be performed at a time after the initial surgery is completed. In addition, there may be other diagnostic tests that your doctor will discuss with you.

What are the treatment options of medulloblastoma?

Your child's physician will determine a specific course of medulloblastoma treatment based on several factors, including:

  • your child's age, overall health, and medical history
  • type, location, and size of the tumor
  • the extent of the disease
  • your child's tolerance for specific medications, procedures, or therapies
  • how your child's doctors expect the disease to behave

There are a number of treatments we may recommend. Some of them help to treat the tumor while others are intended to address complications of the disease or side effects of the treatment.

In all cases, a multidisciplinary team is necessary to optimize care. The team may include members from neurosurgery, neuro-oncology, neurology, radiation oncology, and stem cell transplantation, as well as psychology/social work, nutrition, physical and occupational therapy, and the school liaison program. 

Treatment may include (alone or in combination) Endoscopic third ventriculostomy (ETV) or ventriculo-peritoneal shunt (VP shunt) tumor in the brain can cause blockage of cerebral spinal fluid, the fluid that bathes the brain and spinal cord. If this occurs, our pediatric neurosurgeons may perform a procedure to relieve symptoms of hydrocephalus, the build-up of fluid, which causes increased pressure within the skull.

In an endoscopic third ventriculostomy, surgeons create a small hole that allows fluid to flow around the blockage and into the spinal column. About 90 percent of children with symptoms of hydrocephalus will undergo this procedure.

In some cases, children may have an alternative procedure in which a tube is installed to drain excess fluid into the abdomen (VP shunt).

Surgery

Surgery may be needed to treat hydrocephalus and to remove the tumor. Research has shown that the more completely the tumor is removed, the better the outcome may be. Therefore, your child's surgeon will remove as much of the tumor as safely as possible, while avoiding neurological side effects.

Radiation therapy 

This treatment uses high-energy waves from a specialized machine to damage or kill cancer cells and shrink tumors. Your child's physician will work with pediatric radiation oncologists to determine the optimal dose of radiation that will effectively treat the tumor while avoiding side effects as much as possible.

Chemotherapy

This is a group of drugs that interfere with the cancer cell's ability to grow. Different groups of chemotherapy drugs work in different ways to fight cancer cells and shrink tumors. Your child may receive chemotherapy orally (as a pill to swallow), intramuscularly (as an injection into the muscle or fat tissue), intravenously (as a direct injection into the bloodstream) or intrathecally (as a direct injection into the spinal column through a needle).

What are possible issues after surgery?

After the operation, your child may have difficulties with coordination, weakness in his extremities, and problems with balance. These typically resolve over a course of several weeks. Our physical and occupational therapists will work with your child to treat these issues.

"Posterior fossa mutism" is a condition that may occur after surgery. Within 24 hours, the child develops an inability to speak, has problems with balance and has difficulty with swallowing. The condition may range from mild to severe. The cause of this condition is not entirely known, but it is unique to this area of the brain.

In about 15 percent of the children diagnosed with medulloblastoma, hydrocephalus may develop, requiring a procedure to drain spinal fluid. These procedures are performed by our pediatric neurosurgeons.