Medulloblastoma

Medulloblastomas are a type of childhood solid tumor that is highly undifferentiated, fast-growing, and extremely aggressive, with the poorest prognosis. The cornerstones of first-line treatment for these aggressive embryonal tumors, which are the most common primary malignant brain cancer in children, remain maximal safe resection, craniospinal irradiation (CSI), and chemotherapy.

Harvey Cushing was the first to propose the term medulloblastoma in 1930. Different writers initially referred to these tumors as spongioblastoma indifferentiale, spongioblastoma multiforme, spongioblastoma cerebelli, or simply spongioblastoma. Cushing assumed that this group of tumors came from the medulloblast, one of the five pluripotent stem cells considered to populate the primitive human neural tube. In the meantime, it has been demonstrated that the concept of a medulloblast-like embryonal cell does not exist. As a result, the name medulloblastoma, which Cushing incorrectly invented and which has been so deeply entrenched in the nomenclature, is a misnomer.

Until the 1960s, medulloblastomas were regarded as one of the most dismal illnesses in neurosurgery, with survival rates remaining as low as they were in the early days of neurosurgery when posterior fossa tumors were the most dangerous. Enhanced research, improved diagnostic, surgical, and radiation technologies, as well as newer and more effective chemotherapy treatments, have resulted in significantly improved patient outcomes. Despite aggressive treatment strategies, a considerable clinical challenge still exists due to acute presentation, quick growth, rapid clinical course, and early fatal termination, resulting in a large proportion of morbidity and death.