Medulloblastoma

Definition:

• Primitive neuroectodermal tumor (PNET) of the cerebellum. Highly malignant and fast-growing.

Epidemiology:

• Most common malignant brain tumor in children.
• Peak incidence: 3–8 years.

Location:

• Posterior fossa (cerebellar vermis).

Clinical Features:

• Headache, vomiting (due to raised ICP)
• Ataxia, gait disturbances
• Hydrocephalus possible

Treatment & Pharmacist Role:

1. Surgery – maximal safe resection.
2. Radiotherapy – craniospinal irradiation (post-op).
3. Chemotherapy – often cisplatin, vincristine, cyclophosphamide:
   • Monitor for nephrotoxicity (cisplatin), neuropathy (vincristine), myelosuppression (cyclophosphamide).
   • Supportive care: hydration, antiemetics, growth factor support if needed.

Pharmacist Notes:

• Dose adjustments may be required for renal dysfunction (cisplatin).
• Be alert for drug-drug interactions with anti-seizure or antiemetic therapy.
• Long-term monitoring: ototoxicity, neurocognitive effects.