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000143633 0247_ $$2doi$$a10.1093/neuros/nyz148
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000143633 0247_ $$2ISSN$$a0148-396X
000143633 0247_ $$2ISSN$$a1081-1281
000143633 0247_ $$2ISSN$$a1524-4040
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000143633 037__ $$aDKFZ-2019-01210
000143633 041__ $$aeng
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000143633 1001_ $$aReisinger, Dominik$$b0
000143633 245__ $$aPredisposition of Wingless Subgroup Medulloblastoma for Primary Tumor Hemorrhage.
000143633 260__ $$aOxford$$bOxford University Press$$c2020
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000143633 500__ $$a2020 Apr 1;86(4):478-484
000143633 520__ $$aPrimary intratumoral hemorrhage as a presenting sign is rare in children with medulloblastomas but may result in severe complications. Given the distinct properties of molecular medulloblastoma subgroups, the impact on neurosurgical practice has still to be defined.To investigate both clinical and radiological presentation of intratumoral hemorrhage in medulloblastoma patients in the context of molecular subgroups.Data of all consecutive medulloblastoma patients treated at our institution between 1993 and 2018 (n = 104) were retrospectively reviewed in respect of clinical and radiological presentation as well as molecular subgroups. For cases with available tumor tissue (n = 86), subgroups were assigned by either 450 K methylation array or immunohistochemistry and CTNNB1 sequencing. Available imaging at diagnosis (n = 62) was reviewed by an experienced neuroradiologist.Within the entire cohort, 4 patients (4%) presented with massive spontaneous hemorrhage. Although no patient died as a direct consequence of hemorrhage, all suffered from serious sequelae. Moreover, 3 additional patients displayed radiological evidence of significant hemorrhage. Interestingly, all 7 cases belonged to the wingless (WNT) subgroup (n = 13), resulting in intratumoral hemorrhage in 54% (7/13) of pediatric WNT medulloblastomas. In contrast, significant hemorrhage was absent in all other molecular subgroups.Our results suggest that a substantial proportion of pediatric WNT medulloblastomas display significant intratumoral hemorrhage at the time of diagnosis. Consequently, the presence of significant hemorrhage in fourth ventricle childhood tumors is suggestive of WNT medulloblastoma and should lead to a less aggressive attempt for total resection in this prognostically favorable tumor type.
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000143633 7001_ $$aGojo, Johannes$$b1
000143633 7001_ $$aKasprian, Gregor$$b2
000143633 7001_ $$aHaberler, Christine$$b3
000143633 7001_ $$aPeyrl, Andreas$$b4
000143633 7001_ $$aAzizi, Amedeo A$$b5
000143633 7001_ $$aMayr, Lisa$$b6
000143633 7001_ $$aChocholous, Monika$$b7
000143633 7001_ $$0P:(DE-He78)4c28e2aade5f44d8eca9dd8e97638ec8$$aKool, Marcel$$b8$$udkfz
000143633 7001_ $$aCzech, Thomas$$b9
000143633 7001_ $$aSlavc, Irene$$b10
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000143633 9141_ $$y2020
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