Presentation
The patient has been experiencing moderate holocranial headaches that have been evolving for two years. They have had increasing severity in the last three months and have been accompanied by nausea and vomiting.
Patient Data
Posterior fossa with intra-axial lesions on the left hemispheric cerebellum, irregular shape, lobulated, well-circumscribed margins, signal intensity heterogeneous predominantly hypo intensity on T1 and hyperintensity on T2, isointense on FLAIR regard white matter, with restriction on diffusion and intense homogeneous enhancement after gadolinium administration. Exerts mass effect by amygdale herniation.
Macroscopic description:
Specimen is received fresh for its transoperative study, referred to as the "left cerebellar tumor", consisting of two fragments of tissue, the largest measuring 1.3 x 1 x 0.5 cm and the smallest measuring 1 x 0.5 x 0.3 cm; both are reddish in color with irregular edges and of friable consistency. Imprinting and cutting by freezing.
Transportive biopsy diagnosis: small, round, and blue-cell tumor.
It is received in a container with formalin labeled with the data of the patient referred to as "left cerebellar tumor", which consists of two fragments, the largest measuring 1.3 x 1 x 0.4 cm and having a soft consistency.
They are included in their entirety in two capsules.
List of capsules:
a) cut by freezing; b) the rest of the material; c-d) definitive.
Diagnosis: left cerebellar tumor, rection: classic medulloblastoma, WHO grade IV.
Case Discussion
Medulloblastoma is an embryonic neuroepithelial tumor that originates from primitive multipotent cells of the cerebellum, lateral medullary vellum, and cerebellar flocculus. It is the second most common primary brain neoplasm in children. In the adult population, medulloblastoma tends to be in an atypical location. The usual clinical presentation includes symptoms of obstructive hydrocephalus or cerebellar dysfunction such as headache, vomiting, ataxia, or nausea.
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