Medulloblastoma or neurogliocytoma is a malignant tumour arising from the embryonic cells mainly in children. As a rule, the tumour is located in the posterior cranial fossa. Tumour can spread metastases, but, normally, it wouldn’t exceed the central nervous system borders.
Causes and risk factors of medulloblastoma have not been found yet.
Two syndromes are emphasised in the clinical picture of medulloblastoma and they are:
Romberg's posture when a patient takes a position with shifted feet, outstretched arms and his head lifted is used to identify ataxy syndrome. If the symptoms are positive, a patient’s body might swing and even fall.
Other signs for Ataxy Syndrome are:
If the tumour spreads metastases, there are some other foci symptoms associated to the impaired function of the cranial or spinal nerves whereby verbal, motor, sensory and other neurological disorders may occur.
Visualization techniques largely form the basis for diagnostics. If you really want to receive the right diagnosis it is vital to go to a hospital with the best medical equipment and highly-experienced doctors. The thing is that specialists have to differentiate medulloblastoma from the other central nervous system tumours according to the external signs.
Professionals in German hospitals successfully deal with these diagnostics and use the following techniques for that:
During differential diagnostics, a test is conducted to detect the presence of metastases by introducing a contrasting agent. Doctors examine both the brain and the spinal cord and prefer MRI for the procedure.
Other techniques that help in the diagnostics of medulloblastoma:
Atypical cells in the cerebrospinal fluid indicate the spread of the oncological process. This is an unfavourable prognostic factor.
Standard medulloblastoma treatment scheme includes surgical intervention, chemotherapy and radiation therapy. Therapeutic tactics is defined relying on the risk group, which are two or four depending on the genetic tests. Various changes in the tumour genes may provide favourable or otherwise prognosis and help to choose the best medicines for the chemotherapy.
Surgical treatment is the key method allowing to considerably prolong the patient’s life expectancy. If there is a chance, the tumour is completely removed as it ensure a way better prognosis. Subtotal resection is performed if the tumour has grown into the bottom of the fourth ventricle or the brain stem.
Medulloblastoma responds well to chemotherapy. Therefore, patients are prescribed certain medicines or their combinations to prevent further cancer development. Chemotherapy is prescribed after the surgery or instead of it if the tumour is irresectable.
Radiation therapy is used during the postoperative period. The dose of radiation is minimised for children under 3 years old. In addition to targeted irradiation of possible tumour residues, high-risk patients can be prescribed low-dose radiation of the entire area of the spinal cord and brain in order to destroy possible metastases.
Treatment in Europe, especially treatment in Germany is way more effective as compared to developing countries. Thus, the best decision citizens, who are unhappy with their local healthcare regime, can make is to choose treatment abroad. Medical tourism to a reputable German hospital is actually possible.
There is also news about autologous stem cells transplantation which may considerably prolong the lives of children suffering from medulloblastoma. Currently, the treatment technique is not yet included into the standard protocols for the provision of medical care to patients with this disease. But research in this direction is ongoing, and their results inspire optimism.
Doctors from developed countries are starting to use genetic tests of the tumour cells to select the best method of chemotherapy. Clinical trials are still ongoing, but it is already known that, according to the peculiarities of genetic changes inside the cells of medulloblastoma, it will be possible to judge which schemes of drug use will be most effective for each individual patient.
Scientists are also inventing new medicines for the targeted medulloblastoma therapy. Drugs will react with the special protein molecules located on the surface of the malformation cells. Healthy cells don’t have these proteins and medicines are not going to have any impact on them, therefore leaving them unharmed.
5-year-survival of the patient suffering from all the types of primitive neuroectodermal tumours is 60-65%. Nonetheless, medulloblastoma is peculiar with the best prognosis among all of them and has a 75% median survival rate.
Unfavourable prognostic factors are:
Survival rate of the high-risk group patients is much lower at around 35-40%. The worst prognosis is peculiar for the tumour recurrence after the surgical treatment. If medulloblastoma occurs at the same spot, median life-expectancy of these patients is one and a half years.
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