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There are some peculiar differences between childhood and adulthood medulloblastomas.
The desmoplastic form is found more commonly in adulthood (20–40%) than in pediatrics (10%).
How to cite this URL: Al Anazi AH, Hendam AT, Al Nemer AM, Al Anazi RA. Saudi J Med Med Sci [serial online] 2017 [cited 2018 Jan 12];1-4. 2017/5/2/181/204861Adult medulloblastoma has a higher proportion of desmoplastic histological characteristics than medulloblastoma in children, and it has a higher incidence within the cerebellar hemispheres, thus featuring different proliferative and apoptotic indices and having a tendency for late relapse.
A 31-year-old, Saudi soldier living in Hafr Al-Batin presented with a headache, vomiting, blurring of vision, positive Romberg test and reported a gait disturbance of 1-month duration.
Figure 4: (a) Desmoplastic medulloblastoma, histologic and immunohistochemical features.
(a) Note nodules of rounded, primitive neoplastic cells (H and E, ×200).
The turnover (mitosis and necrosis) was high, with Ki67 positivity in 80% of the neoplastic cells [Figure 4c].
Immunohistochemical stains showed weak reactivity of the neoplastic cells for neuron-specific enolase [Figure 4d] and neurofilament proteins and focal reactivity for glial fibrillary acidic protein. There was no reactivity for synaptophysin of epithelial membrane antigen.
A computed tomography (CT) of the brain showed a right cerebellar heterogeneous mass a ffecting the fourth ventricle with dilation of the third and lateral ventricles with transependymal edema.Most authors agree on a hematogenous route of spread.