Radiological progression of medulloblastoma from non-existence to symptomatic mass in 42 days: Case report, kinetic analysis, and literature review

Abstract

Introduction: Medulloblastoma (MB) is the most common malignant brain tumor in children, characterized by its aggressive nature and rapid growth. However, the standard practice of immediate surgical intervention limits opportunities to study the tumor's doubling time (DT), thereby restricting our understanding of its growth kinetics.

Research question: This study presents a pediatric case of MB that developed within 42 days of a normal MRI, with a focus on analyzing the tumor's DT and comparing it with values reported in the literature.

Materials and methods: Tumor kinetics were assessed using volumetric measurements obtained via 3D Slicer software. A literature review identified six studies that examined the radiological DT of medulloblastoma for comparative analysis.

Results: The estimated DT for the presented case ranged between 2 and 6.5 days, indicating exceptionally rapid tumor proliferation. This is shorter than previously reported cases, where DTs ranged from 6.84 to 353 days. Including the current case, the mean DT across all cases is 53.8 days.

Discussion and conclusion: This case highlights the potential for extremely rapid progression in MB, underscoring the aggressive nature of this tumor. The findings emphasize the importance of prompt diagnosis and intervention in MB cases. Further research into the genetic and molecular mechanisms driving its aggressive growth could support the development of targeted therapeutic strategies.

Keywords: Doubling time; Growth rate; Kinetic analysis; Medulloblastoma; Neuro-oncology; Pediatric.

Fig. 1

Contrasted brain MRI at 182 days old. (A) Axial view demonstrating heterogeneously enhancing solid mass occupying the right cerebellopontine angle (CPA). (B) Sagittal view demonstrates the mass in the right CPA, the cystic intracerebellar component, and the dilated lateral ventricles. (C) Axial view demonstrating cerebellar multilobulated cystic component. (D) Sagittal view demonstrates the cystic component, the solid component extending through the foramen magnum, and the dilated third and lateral ventricles.

Fig. 2

Snapshot from 3D Slicer software showing a 3D model of the tumor created using the Segment Editor module.

Fig. 3

Regression analysis of patient age and radiological DT across current and reviewed cases.: The current case DT is represented at 4.3, the average of the calculated range. DT: doubling time.