Meduloblastoma em Adultos
DOI:
https://doi.org/10.34024/rnc.1999.v7.10314Palavras-chave:
Meduloblastoma, adulto, manifestações, clínicas, tratamentoResumo
Meduloblastomas representam 1% dos tumores intracranianos e 6% dos tumores de fossa posterior nos adultos. A incidência populacional neste grupo é de, aproximadamente, 0,5 milhão/ ano. O sexo masculino é o mais acometido e o quadro clínico predominante é de cefaléia e síndrome cerebelar. Nos adultos, essa neoplasia localiza-se, preferencialmente, nos hemisférios cerebelares, sendo o subtipo histológico desmoplásico mais freqüente. Na maioria dos casos, o tumor está limitado à fossa posterior ao diagnóstico. O tratamento inclui ressecção cirúrgica mais ampla possível, associada à radioterapia cranioespinhal com reforço em fossa posterior e, sempre que possível, quimioterapia adjuvante. O tratamento adequado permitirá um melhor controle da doença e uma maior sobrevida. A recidiva tardia é mais comum nos adultos, sendo necessário um longo seguimento desses pacientes. A sobrevida total de adultos com meduloblastomas parece ser
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Referências
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9. Miles J & Bhandari YS. Cerebellar medulloblastoma in adults: review of 18 cases. J Neurol Neurosurg Psychiat, 33:208211, 1970.
10. Hubbard JL, Scheithauer BW, Kispert DB et al. Adult cerebelar medulloblastoma: the patological, radiographic, and clinical spectrum. J Neurosurg, 70:536-544, 1989.
11. Sharma BS, Kak VK, Mittal RS et al. Medulloblastoma in adults – clinical observations and results of treatment. Indian J Cancer, 26:156-163, 1989. 12. Russel DS & Rubinstein LJ. Pathology of tumors of the nervous system. Baltimore. Williams & Wilkins, 1989.
13. Farwell JR & Flannery JT. Adult ocurrence of medulloblastoma. Acta Neurochirurgica (Wien), 86:1-5, 1987.
14. Carrie C, Lasset C, Alapetite C et al. Multivariate analysis of prognostic factors in adult patients with medulloblastoma. A retrospective study of 156 patients. Cancer, 74:2352-2360, 1994.
15. Giordana MT, Schiffer P, Lanotte M et al. Epidemiology of adult medulloblastoma. Int J Cancer, 80:689-692, 1999.
16. Iaconetta G, Lamaida E, Rossi A et al. Cerebelar medulloblastoma in adults: report of 15 cases and review of the literature. Acta Neurol (Napoli), 16:38-45, 1994.
17. Sheikh BY & Kanaan IN. Medulloblastoma in adults. J Neurosurg Sci, 38:229-234, 1994.
18. Prados MD, Warnick RE, Wara WM et al. Medulloblastoma in adults. Int J Radiat Oncol Biol Phys, 32:1145-1152, 1995.
19. Rorke LB. The cerebelar medulloblastoma and its relationship to primitive neuroectodermal tumors. J Neuropathol Exp Neurol, 42:1-15, 1983.
20. Tomlinson FH, Scheithauer BW, Jenkins RB. Medulloblastoma: II. A pathobiologic overview. J Child Dis, 7:240252, 1992.
21. Schiff D & Wen PY. Uncommon brain tumors. In: WEN PY & BLACK PM, ed. – Brain tumors in adults. Philadelphia, WB SAUDERS COMPANY, 1995, p. 953-974. (Neurologic Clinics, 13).
22. Giangaspero F, Cenacchi G, Roncaroli F et al. Medullocytoma (lipidized medulloblastoma). A cerebelar neoplasm of adults with favorable prognosis. Am J Surg Pathol, 20:656-664, 1996.
23. Soylemezoglu F, Soffer D, Onol B et al. Lipomatous medulloblastoma in adults. A distinct clinicopathological entity. Am J Surg Pathol, 20(4):413-418, 1996.
24. Stávale JN. Contribuição para histogênese da variante desmoplásica do meduloblastoma. São Paulo, 1989. (Tese de doutorado – Escola Paulista de Medicina – Unifesp).
25. Chatty EM & Earle KM. Medulloblastoma. A report of 201 cases with emphasis on the relationship of histologic variants to survival. Cancer, 28:977-983, 1971.
26. Choux M, Lena G, Hassoun J. Prognosis and long term follow-up in patients with medulloblastoma. Clin Neurosurg, 30:246-277, 1983.
27. Rubinstein LJ & Northfield DWC. The medulloblastoma and the so-called "arachnoidal cerebellar sarcoma". A critical reexamination of a nosological problem. Brain, 87:379-410, 1964.
28. Tomlinson FH, Scheithauer BW, Jenkins RB. Medulloblastoma: I. Clinical, diagnostic and therapeutic overview. J Child Dis, 7:142-155, 1992.
29. Thapar K, Fukuyama K, Rutka JT. Neurogenetics and the molecular biology of human brain tumors. In: Kaye AH & Laws Jr ER. – Brain Tumors (An Encyclopedic Approach). New York, Churchill Livingstone, 1995, p. 69-97.
30. Scheurlen WG, Schwabe GC, Joos S et al. Molecular analysis of childhood primitive neuroectodermal tumors defines markers associated with poor outcome. J Clin Oncol, 16:2478-2485, 1998.
31. López-Ginés C, Cerdá-Nicolás M, Gil-Benso R et al. Involvement of the long arm of cromosome 9 in medulloblastoma in an adult. Cancer Genet Cytogenet, 96:81-84, 1997.
32. Bigner SH, Mark J, Friedman HS. Structural chromosomal abnormalities in human medulloblastoma. Cancer Genet Cytogenet, 30:91-101, 1988.
33. Hazuka MB, Debiose DA, Henderson RH et al. Survival results in adult patients treated for medulloblastoma. Cancer, 69:2143-2148, 1992.
34. Peterson K & Walker RW. Medulloblastoma/primitive neuroectodermal tumor in 45 adults. Neurology, 45:440-442, 1995.
35. Kleinman GM, Hochberg FH, Richardson EP. Systemic metastases from medulloblastoma: report of two cases and review of the literature. Cancer, 48:2296-2309, 1981.
36. Pollono DG, Tomarchio S, Drut R. Meningeal signs as the presenting feature of medulloblastoma. Med Pediatr Oncol, 32:477-478, 1999.
37. Bourgouin PM, Tampieri D, Grahovac SZ et al. CT and MR imaging findings in adults with cerebelar medulloblastoma: comparison with findings in children. A J R, 159:609-612, 1992.
38. Grabenbauer GG, Beck JD, Erhardt J et al. Postoperative radiatiotherapy of medulloblastoma. Impact of radiation quality on treatment outcome. Am J Clin Oncol, 19:73-77, 1996.
39. Skolyszewski J & Glínski B. Results of postoperative irradiation of medulloblastoma in adults. Int J Radiat Oncol Biol Phys, 16:479-482, 1989.
40. Kramer JH, Crowe AB, Larson DA et al. Neuropsychological sequelae of medulloblastoma in adults. Int J Radiat Oncol Biol Phys, 38:21-26, 1997.
41. Packer RJ, Sutton LN, Elterman R et al. Outcome for children with medulloblastoma treated with radiation and cisplatin, CCNU, and vincristine chemotherapy. J Neurosurg, 81:690698, 1994.
42. Bloom HJG & Bessel EM. Medulloblastoma in adults: a review of 47 patients between 1952 and 1981. Int J Radiat Oncol Biol Phys, 18:763-772, 1990. 43. Galanis E, Buckner JC, Schomberg PJ et al. Effective chemotherapy for advanced CNS embryonal tumors in adults. J Clin Oncol, 15:2939-2944, 1997. 44. Fukunaga-Johnson N, Lee JH, Sandler HM. Patterns of failure following treatment for medulloblastoma: is it necessary to treat the entire posterior fossa? Int J Radiat Oncol Biol Phys, 42:143-146, 1998.
2. ed. Berlin, Springer-Verlag, 1993, p.2730. (World Health Organization: International Histological Classification of Tumors). 2. Duffner P, Krischer JP, Horowitz ME et al. Second malignancies in young children with primary brain tumors following treatment with prolonged postoperative chemotherapy and delayed irradiation: a Pediatric Oncology Group Study. Ann Neurol, 44:313-316, 1998.
3. Packer RJ. Brain tumors in children. Arch Neurol, 56:421425, 1999.
4. Kuijten R & Bunin GR. Risk factors for childhood brain tumors. Cancer Epidemiol Biomarker Prevention, 2:277-288, 1993.
5. Bailey P & Cushing H. Medulloblastoma cerebelli: a common type of midcerebellar glioma of childhood. Arch Neurol Psychiatr, 14:192-224, 1925.
6. Evans AE, Jenkins RDT, Sposto R et al. The treatment of medulloblastoma: results of a prospective randomized trial of radiation therapy with and without CCNU, vincristine, and predinisone. J Neurosurg, 72:572-582, 1990.
7. Packer RJ & Finlay JL. Medulloblastoma: presentation, diagnosis and management. Oncology, 2:35-49, 1988.
8. Crist WM, Ragab AH, Vietti TJ et al. Chemotherapy of childhood medulloblastoma. Am J Dis Child, 130:639-642, 1976.
9. Miles J & Bhandari YS. Cerebellar medulloblastoma in adults: review of 18 cases. J Neurol Neurosurg Psychiat, 33:208211, 1970.
10. Hubbard JL, Scheithauer BW, Kispert DB et al. Adult cerebelar medulloblastoma: the patological, radiographic, and clinical spectrum. J Neurosurg, 70:536-544, 1989.
11. Sharma BS, Kak VK, Mittal RS et al. Medulloblastoma in adults – clinical observations and results of treatment. Indian J Cancer, 26:156-163, 1989. 12. Russel DS & Rubinstein LJ. Pathology of tumors of the nervous system. Baltimore. Williams & Wilkins, 1989.
13. Farwell JR & Flannery JT. Adult ocurrence of medulloblastoma. Acta Neurochirurgica (Wien), 86:1-5, 1987.
14. Carrie C, Lasset C, Alapetite C et al. Multivariate analysis of prognostic factors in adult patients with medulloblastoma. A retrospective study of 156 patients. Cancer, 74:2352-2360, 1994.
15. Giordana MT, Schiffer P, Lanotte M et al. Epidemiology of adult medulloblastoma. Int J Cancer, 80:689-692, 1999.
16. Iaconetta G, Lamaida E, Rossi A et al. Cerebelar medulloblastoma in adults: report of 15 cases and review of the literature. Acta Neurol (Napoli), 16:38-45, 1994.
17. Sheikh BY & Kanaan IN. Medulloblastoma in adults. J Neurosurg Sci, 38:229-234, 1994.
18. Prados MD, Warnick RE, Wara WM et al. Medulloblastoma in adults. Int J Radiat Oncol Biol Phys, 32:1145-1152, 1995.
19. Rorke LB. The cerebelar medulloblastoma and its relationship to primitive neuroectodermal tumors. J Neuropathol Exp Neurol, 42:1-15, 1983.
20. Tomlinson FH, Scheithauer BW, Jenkins RB. Medulloblastoma: II. A pathobiologic overview. J Child Dis, 7:240252, 1992.
21. Schiff D & Wen PY. Uncommon brain tumors. In: WEN PY & BLACK PM, ed. – Brain tumors in adults. Philadelphia, WB SAUDERS COMPANY, 1995, p. 953-974. (Neurologic Clinics, 13).
22. Giangaspero F, Cenacchi G, Roncaroli F et al. Medullocytoma (lipidized medulloblastoma). A cerebelar neoplasm of adults with favorable prognosis. Am J Surg Pathol, 20:656-664, 1996.
23. Soylemezoglu F, Soffer D, Onol B et al. Lipomatous medulloblastoma in adults. A distinct clinicopathological entity. Am J Surg Pathol, 20(4):413-418, 1996.
24. Stávale JN. Contribuição para histogênese da variante desmoplásica do meduloblastoma. São Paulo, 1989. (Tese de doutorado – Escola Paulista de Medicina – Unifesp).
25. Chatty EM & Earle KM. Medulloblastoma. A report of 201 cases with emphasis on the relationship of histologic variants to survival. Cancer, 28:977-983, 1971.
26. Choux M, Lena G, Hassoun J. Prognosis and long term follow-up in patients with medulloblastoma. Clin Neurosurg, 30:246-277, 1983.
27. Rubinstein LJ & Northfield DWC. The medulloblastoma and the so-called "arachnoidal cerebellar sarcoma". A critical reexamination of a nosological problem. Brain, 87:379-410, 1964.
28. Tomlinson FH, Scheithauer BW, Jenkins RB. Medulloblastoma: I. Clinical, diagnostic and therapeutic overview. J Child Dis, 7:142-155, 1992.
29. Thapar K, Fukuyama K, Rutka JT. Neurogenetics and the molecular biology of human brain tumors. In: Kaye AH & Laws Jr ER. – Brain Tumors (An Encyclopedic Approach). New York, Churchill Livingstone, 1995, p. 69-97.
30. Scheurlen WG, Schwabe GC, Joos S et al. Molecular analysis of childhood primitive neuroectodermal tumors defines markers associated with poor outcome. J Clin Oncol, 16:2478-2485, 1998.
31. López-Ginés C, Cerdá-Nicolás M, Gil-Benso R et al. Involvement of the long arm of cromosome 9 in medulloblastoma in an adult. Cancer Genet Cytogenet, 96:81-84, 1997.
32. Bigner SH, Mark J, Friedman HS. Structural chromosomal abnormalities in human medulloblastoma. Cancer Genet Cytogenet, 30:91-101, 1988.
33. Hazuka MB, Debiose DA, Henderson RH et al. Survival results in adult patients treated for medulloblastoma. Cancer, 69:2143-2148, 1992.
34. Peterson K & Walker RW. Medulloblastoma/primitive neuroectodermal tumor in 45 adults. Neurology, 45:440-442, 1995.
35. Kleinman GM, Hochberg FH, Richardson EP. Systemic metastases from medulloblastoma: report of two cases and review of the literature. Cancer, 48:2296-2309, 1981.
36. Pollono DG, Tomarchio S, Drut R. Meningeal signs as the presenting feature of medulloblastoma. Med Pediatr Oncol, 32:477-478, 1999.
37. Bourgouin PM, Tampieri D, Grahovac SZ et al. CT and MR imaging findings in adults with cerebelar medulloblastoma: comparison with findings in children. A J R, 159:609-612, 1992.
38. Grabenbauer GG, Beck JD, Erhardt J et al. Postoperative radiatiotherapy of medulloblastoma. Impact of radiation quality on treatment outcome. Am J Clin Oncol, 19:73-77, 1996.
39. Skolyszewski J & Glínski B. Results of postoperative irradiation of medulloblastoma in adults. Int J Radiat Oncol Biol Phys, 16:479-482, 1989.
40. Kramer JH, Crowe AB, Larson DA et al. Neuropsychological sequelae of medulloblastoma in adults. Int J Radiat Oncol Biol Phys, 38:21-26, 1997.
41. Packer RJ, Sutton LN, Elterman R et al. Outcome for children with medulloblastoma treated with radiation and cisplatin, CCNU, and vincristine chemotherapy. J Neurosurg, 81:690698, 1994.
42. Bloom HJG & Bessel EM. Medulloblastoma in adults: a review of 47 patients between 1952 and 1981. Int J Radiat Oncol Biol Phys, 18:763-772, 1990. 43. Galanis E, Buckner JC, Schomberg PJ et al. Effective chemotherapy for advanced CNS embryonal tumors in adults. J Clin Oncol, 15:2939-2944, 1997. 44. Fukunaga-Johnson N, Lee JH, Sandler HM. Patterns of failure following treatment for medulloblastoma: is it necessary to treat the entire posterior fossa? Int J Radiat Oncol Biol Phys, 42:143-146, 1998.
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1999-09-30
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Franco, C. M. R. ., Malheiros, S. M. F., & Gabbai , A. A. (1999). Meduloblastoma em Adultos. Revista Neurociências, 7(3), 129–135. https://doi.org/10.34024/rnc.1999.v7.10314
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Recebido: 2020-02-18
Publicado: 1999-09-30
Publicado: 1999-09-30
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