Clinical Neuroradiology, 2018, Vol.28(1), pp.99-107
To access, purchase, authenticate, or subscribe to the full-text of this article, please visit this link: http://dx.doi.org/10.1007/s00062-016-0517-0 Byline: Dagmar Beier (1,2,3), Selin Kocakaya (3), Peter Hau (4), Christoph Patrick Beier (1,2,3) Keywords: Adult; Medulloblastoma; Magnetic resonance imaging; Computed tomography; Contrast enhancement Abstract: Purpose Current knowledge on the spectrum of the neuroradiological appearance of adult medulloblastoma is sparse. Due to the rarity of the disease, adult patients were generally diagnosed and treated similar to children however, pediatric and adult medulloblastomas display substantial molecular differences that may influence the neuroradiological phenotype. This study therefore aimed at assessment of the neuroradiological spectrum of adult medulloblastoma in comparison to pediatric tumors. Methods All available publications on adult medulloblastoma published until June 2013 were screened for imaging data on single patients. A total of 109 patients were identified and compared to 118 pediatric patients described in 4 cohorts. Results The average age of the adult patients was 34.3 years. Most adult medulloblastomas (57.6%) were localized laterally (vs. 14.4% in pediatric patients). On T1-weighted sequences, only 41.1% of all adult medulloblastomas appeared hypointense (vs. 89.3%) and 69.6% were hyperintense on T2 sequences (vs. 83%). In contrast to pediatric patients only 53.3% showed strong contrast enhancement (pediatric patients 77.1%), while the contrast uptake of the remainder was described as subtle, moderate or lacking. Contrast enhancement was more often described as inhomogeneous in adults (35.5% as compared to 15.2% in children) and 26.4% had cysts. Conclusion Although the neuroradiological spectrum of medulloblastoma in adults was similar to children, an atypical presentation with inhomogeneous contrast enhancement, more hyperintense signal on T1 and a more hypointense signal on T2-weighted sequences was common. Given the rarity of the tumor, awareness of these differences constitutes a prerequisite to avoid delays in diagnostics. Author Affiliation: (1) 0000 0001 0728 0170, grid.10825.3e, Department of Clinical Research, University of Southern Denmark, Sdr. Boulevard 29, 5000, Odense, Denmark (2) 0000 0004 0512 5013, grid.7143.1, Department of Neurology, University Hospital of Odense, Sdr. Boulevard 29, 5000, Odense, Denmark (3) 0000 0000 8653 1507, grid.412301.5, Department of Neurology, University Hospital Aachen, Pauwelsstra[sz]e 20, 52074, Aachen, Germany (4) 0000 0000 9194 7179, grid.411941.8, Wilhelm Sander NeuroOncology Unit and Department of Neurology, University Hospital Regensburg, Universitatsstra[sz]e 80, 93053, Regensburg, Germany Article History: Registration Date: 28/04/2016 Received Date: 01/02/2016 Accepted Date: 28/04/2016 Online Date: 22/06/2016 Article note: The authors D. Beier and S. Kocakaya contributed equally to the manuscript.
Adult ; Medulloblastoma ; Magnetic resonance imaging ; Computed tomography ; Contrast enhancement
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