Medulloblastoma Diagnosis

If you or your child have symptoms that may signal medulloblastoma, your doctor will perform an exam and ask questions about overall health. The doctor also may do a neurological exam to test reflexes, muscle strength, vision and other functions of the brain and spine.

If anything appears abnormal, the doctor may refer you to a neurologist, neurosurgeon or neuro-oncologist, doctors who specialize in the treatment of nervous system diseases.

One or more of the following diagnostic tests may be used to find out if you or your child have medulloblastoma and if it has spread. These tests also may be used to find out if treatment is working.

Imaging tests, including:

• CT (computed tomography) scans
• MRI (magnetic resonance imaging) of the brain and spine
• PET (positive emission tomography) scan

Surgery: If an MRI or CT of the brain shows a tumor in the lower part of the back of the brain, medulloblastoma may be a possibility. In an operation called a craniotomy, all or part of the brain tumor is removed. This is needed to confirm the diagnosis and is the first step of treatment. If tumor removal is not possible, a biopsy may be needed. In a biopsy, a small sample is removed from the tumor and looked at with a microscope to confirm the diagnosis.

In addition to tumor removal, additional tests are required to evaluate how much the disease has spread from its original site and decide the best course of treatment. These tests include:

• A brain MRI obtained after tumor removal
• A whole spine MRI
• A spinal tap, or lumbar puncture). During this procedure, a small amount of cerebrospinal fluid (clear liquid in and around the brain and spine) is removed with a needle from the spinal canal. It is then examined with a microscope to determine if tumor cells have spread into the cerebrospinal fluid.
• A CT or a PET scan of the body may be needed in some cases to determine if the tumor has spread outside of the nervous system

Medulloblastoma second opinions

The pediatric cancer experts at Children’s Cancer Hospital and the adult cancer experts at the Anne C. Brooks Brain and Spine Center welcome the opportunity to provide second opinions for medulloblastoma.

If you would like to get a second opinion, call 844-566-8470 to make an appointment or request an appointment online.

Medulloblastoma Classification

After a medulloblastoma has been surgically removed, it will be classified in one of two categories.

Standard risk medulloblastoma:

• Less than 1.5 centimeters of tumor is left after surgery
• Cancer has not spread to another part of the nervous system or the body
• Patient is at least three years old or older

High-risk medulloblastoma:

• More than 1.5 centimeters of tumor is left after surgery or cancer has spread to another part of the nervous system or the body
• Patient is younger than three years old
• Patient has anaplastic/large cell variant of medulloblastoma

Research has identified at least four distinct subtypes of medulloblastoma in children. In adults, preliminary research has identified three main subtypes of medulloblastoma, and research is ongoing to better define the best treatment for each.