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Washington University Experience | NEOPLASMS (EMBRYONAL) | Medulloblastoma, Histologically Defined | Classic Subtype | 2A0 Case 2 History
Case 2 History ---- The decedent was a 33-year-old male with a history of posterior fossa medulloblastoma, initially diagnosed 14 years previously in 2004 as having a small area of desmoplasia but not subsequently meriting that designation in later resections. He is status post craniotomy for tumor resection followed by adjuvant craniospinal radiation and chemotherapy in 2004-2005. He had recurrent disease in the region of the corpus callosum and posterior fossa in late 2015. He underwent a biopsy in 1/2016 and received proton radiation to the frontal lobe for a month. At that time GPS analysis showed a mutation in PTCH1. In 6/2016, he underwent stem cell transplant, which was complicated by left cerebellar stroke and hypoxic respiratory failure requiring intubation. MRI in 5/2017 showed disease progression. Biopsy showed recurrent medulloblastoma with accumulation of more aggressive features, and he received Monteris laser ablation in 05/2017. He was started on Odomzo in 07/2017, which was discontinued in 08/2017 due to disease progression on MRI. He was then started on Avastin every 2 weeks beginning in 09/2017. He received high-dose Temodar but experienced severe cytopenia after the first cycle and was switched to a lower-dose regimen. His chemotherapy regimen was stopped in 01/2018 after evidence of clinical and radiological progression, and he was transitioned to palliative and hospice care. He died in 04/2018, fourteen years after his original diagnosis.
