A Critical Review of Medulloblastoma

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Abstract
The medulloblastoma is a small cell neoplasm of the cerebellum which largely afflicts the pediatric population and has a marked propensity for dissemination along CSF pathways. Since the adaptation of craniospinal irradiation in the 1950's, there has been a substantial improvement in patient prognosis. Now with the addition of aggressive chemotherapy regimens both pre- and post-irradiation, patients with medulloblastoma have a 5-year survival which exceeds 60%. In this review, we discuss our current surgical management of the patient with a medulloblastoma, and the post-operative stratification of the patient into different treatment protocols. We briefly review the relationship of the medulloblastoma to primitive neuroectodermal tumors in the central nervous system. And we summarize current research efforts aimed at increasing our understanding of the medulloblastoma. From a difficult past, neurosurgeons and physicians caring for the patient with a medulloblastoma may look forward to a promising future in which the high-risk patient may be cured.

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