A favorable case of recurrent
medulloblastoma, in which 19 years has elapsed with combination
therapy due to surgery, radiation and
chemotherapy since the initial operation, is reported. The case was a male of age 12 who was admitted due to
medulloblastoma of the classical type.
Tumor recurrences were observed 3 times within 7 years after the initial operation and
radiation treatment. At the 3rd recurrence, a large
tumor was found in the cerebellar vermis and left cerebellar hemisphere on CT with CSF dissemination and a high NSE level in the CSF (62 ng/ml). Only
chemotherapy by
intravenous administration of 2 courses of 120-150 mg
ACNU (1.7-2.2 mg/kg) and 4 mg
vincristine (0.06 mg/kg) with intrathecal administration of
methotrexate was given at this time. The
tumor image and gait disturbance with radicular
pain disappeared completely and the NSE level in the CSF improved to within the normal range (5.4 ng/ml). The patient continues
in complete remission, with a Karnovsky performance status of 100% at 4 years after the 3rd recurrence. We report full details of this case in which active treatments consisting mainly of
chemotherapy proved to be effective for recurrent
medulloblastoma, even though its prognosis is generally very unfavorable.