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8-year-old female presented with a history of increasing headaches for the past month. She has also had neck pain and vomiting in the morning for a few days
Brain MRI: 4.5 cm L cerebellar mass consistent with medulloblastoma. Cystic and necrotic areas are seen with surrounding vasogenic edema. No leptomeningeal seeding of the tumor.
MRI spine: no evidence of drop metastasis.
A 4cm x 3cm tumor was found 10 mm into the cerebellar hemisphere. The mass was fairly vascular, purple-brown in color and bleeding easily. Gross total resection was felt to be achieved.
Left cerebellum tumor: medulloblastoma with focal anaplasia. CSF cytology: negative for tumor cells.
Surgery: Suboccipital craniectomy/C1 laminectomy for gross total tumor resection.
Radiation: Beam radiation started: 2340 cGy to the full craniospinal axis/ 3240 cGy boost to the posterior fossa to a total dose of 5580 cGy
Chemotherapy: Chemotherapy (vincristine) started.