PMID- 10067927
OWN - NLM
STAT- MEDLINE
DCOM- 19990401
LR  - 20041117
IS  - 0022-3085 (Print)
IS  - 0022-3085 (Linking)
VI  - 90
IP  - 3
DP  - 1999 Mar
TI  - Primary cerebellar glioblastomas multiforme in children. Report of four cases.
PG  - 546-50
AB  - Primary cerebellar glioblastomas multiforme are exceedingly rare in children. The 
      authors therefore retrospectively characterized the clinical behavior and 
      pathological features of these tumors. A review of the database at the Hospital 
      for Sick Children, Toronto, Canada revealed four patients with cerebellar tumors 
      that displayed significant pleomorphism, hypercellularity, mitoses, and necrosis 
      with pseudopalisading. The authors performed a detailed clinical, radiological, 
      histological, and immunohistochemical analysis of the tumors in these four 
      children (three boys and one girl; average age at presentation 7 years; range 21 
      months-15 years). Magnetic resonance imaging and computerized tomography most 
      commonly revealed a large lesion with minimal edema, inhomogeneous contrast 
      enhancement, and a discrete border. Tumor resection was subtotal in one patient 
      and gross total in three patients. Immunostaining of the tumor cells with 
      antisera to glial fibrillary acidic protein and vimentin was positive in varying 
      degrees. Initial adjuvant therapy consisted of local radiation only (one 
      patient), chemotherapy only (one patient), and radiation and chemotherapy (one 
      patient). One patient received no adjuvant therapy. Tumor recurrence was 
      documented in all patients: two local recurrences (at 3.5 and 7 months), one 
      spinal recurrence (at 14 months), and one local recurrence with ventricular and 
      spinal spread (at 8 months). Ultimately, three of the four patients developed 
      leptomeningeal tumor spread. Patient follow up ranged from 8 to 17 months (mean 
      12.5 months). Three patients were dead at last follow up with a mean survival of 
      15 months. The prognosis for patients with cerebellar glioblastomas is extremely 
      poor, and the tumor has a tendency for cerebrospinal fluid dissemination. The 
      optimal management of patients harboring of these difficult-to-treat tumors, 
      including the role of craniospinal radiation and chemotherapy, has not yet been 
      achieved.
FAU - Kulkarni, A V
AU  - Kulkarni AV
AD  - Division of Neurosurgery, Hospital for Sick Children, University of Toronto, 
      Ontario, Canada.
FAU - Becker, L E
AU  - Becker LE
FAU - Jay, V
AU  - Jay V
FAU - Armstrong, D C
AU  - Armstrong DC
FAU - Drake, J M
AU  - Drake JM
LA  - eng
PT  - Journal Article
PL  - United States
TA  - J Neurosurg
JT  - Journal of neurosurgery
JID - 0253357
SB  - IM
MH  - Adolescent
MH  - Cerebellar Neoplasms/diagnosis/*surgery
MH  - Child
MH  - Combined Modality Therapy
MH  - Female
MH  - Glioblastoma/diagnosis/*surgery
MH  - Humans
MH  - Infant
MH  - Magnetic Resonance Imaging
MH  - Male
MH  - Neoplasm Recurrence, Local/therapy
MH  - Survival Analysis
MH  - Treatment Failure
EDAT- 1999/03/06 00:00
MHDA- 1999/03/06 00:01
CRDT- 1999/03/06 00:00
PHST- 1999/03/06 00:00 [pubmed]
PHST- 1999/03/06 00:01 [medline]
PHST- 1999/03/06 00:00 [entrez]
AID - 10.3171/jns.1999.90.3.0546 [doi]
PST - ppublish
SO  - J Neurosurg. 1999 Mar;90(3):546-50. doi: 10.3171/jns.1999.90.3.0546.