Extraneural dissemination of cerebellar medulloblastoma detected by 18F-FDG PET/CT – a case report of a rare situation


Authors: Lucia Kaliská 1;  Monika Zacharovská 1;  Marika Vereb 2;  Martin Spurný 3;  Pavel Bician 4;  Robert Chrenko 5;  Soňa Balogová 6
Authors‘ workplace: Inštitút nukleárnej a molekulárnej medicíny, Banská Bystrica, Slovensko 1;  Nuklearmedizin, Klinikum Kassel, Nemecko 2;  M. R Institute, s. r. o., Banská Bystrica, Slovensko 3;  Klinika pediatrickej onkológie a hematológie, Detská fakultná nemocnica, Banská Bystrica, Slovensko 4;  Neurochirurgické oddelenie, Landesklinikum Wiener Neustadt, Rakúsko 5;  Klinika nukleárnej medicíny LF UK a OÚSA, Bratislava, Slovensko 6
Published in: NuklMed 2015;4:73-78
Category: Casuistry

Overview

In patients with medulloblastoma, extraneural metastases are well-known but very rare phenomenon. Herein we report a case of 11-year-old boy with medulloblastoma in cerebellar vermis, with early dissemination in spinal canal, treated by surgery, craniospinal irradiation and high-dose chemotherapy. Three months after completion of treatment, the recurrent disease was identified in frontal lobe. The patient underwent surgery and radiotherapy; second-line chemotherapy was planned. After completion of radiotherapy the mass in left neck area appeared. Histology from lymph node excision confirmed metastasis of immature embryonal tumor, most likely anaplastic variant of medulloblastoma, however neuroblastoma was considered as well. To restage the disease 18F-FDG PET/CT and 123I-MIBG scans were performed. While 123I-MIBG study was completely negative, 18F-FDG PET/CT showed extensive metastatic disease with multiple FDG avid lesions through bone marrow, in lymph nodes and paranasal sinuses. MRI plays a major role in initial staging, grading and prognostic evaluation of medulloblastoma. 18F-FDG PET/CT is not routinely performed in re-staging of medulloblastoma, however, it may be useful to identify distant metastatic spread.

Key Words:
medulloblastoma, extraneural metastases, 18F-FDG PET/CT


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Labels
Nuclear medicine Radiodiagnostics Radiotherapy
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