Medulloblastoma VGHTC PED 20180102. 1. 90% of embryonal CNStumors; a cerebellar tumor; predominantly in males; median age of 5-7 yr ...跳到主要內容區塊最新消息部科簡介部科簡介團隊介紹部主任科主任醫師介紹檢查介紹對外檢查服務心臟檢查服務病房介紹門診科別與症狀對照表地理位置活動花絮衛教專區卓飛症候群專區兒童血液腫瘤科腸病毒專區兒童急診科兒童心臟科兒童免疫風濕科兒童腎臟科常見問答教育訓練兒童血腫科教學臨床教學住院醫師園地工作手冊新生兒科兒童急診科MedicalQuizX-Ray教學實證醫學公開資訊研究發展歷年研究計劃論文發表醫學會活動研究發展與醫療創新分子生物實驗室獲獎常用連結分享中榮首頁單位首頁English選擇分院埔里分院嘉義分院灣橋分院臺中榮民總醫院×:::快捷選單網路掛號看診進度即時動態衛教專區服務諮詢交通指南健康檢查常見問答該看哪一科:::兒童醫學中心>教育訓練>兒童血腫科教學NelsonChapter497Medulloblastoma引用(1)2020/4/810:45:49719NelsonChapter497BrainTumorsinChildhoodbyJoannL.AterandJohnF.KutteschJr.MedulloblastomaVGHTCPED20180102 1.90%ofembryonalCNStumors;acerebellartumor;predominantlyinmales;medianageof5-7yr。

Location:inthemidlinecerebellarvermis;olderpatientsmayinthecerebellarhemisphere.2. CTandMRI:asolid,homogeneous,contrastmedium–enhancingmassintheposteriorfossacausingfourthventricularobstructionandhydrocephalus;upto30%ofpatientswithevidenceofleptomeningealspread.3.Histologicpatterns:amonomorphicsheetofundifferentiatedcellsclassicallynotedassmall,blue,roundcells;presenceofHomerWrightrosettes[(菊形團(rosettes)是腫瘤中細胞聚集成一團的構造、他們的中央通常有輻射狀或暈的排列，而命名的由來是哥德式教堂彩色玻璃中的玫瑰花瓣狀，而菊形團(rosettes)具有很多不同的形態，他們的名稱也不進相同;JamesHomerWright首次對這種類型的菊形團(rosettes)做命名，常見於Neuroblastoma(神經母細胞瘤)、medulloblastomas(髓母細胞瘤)、primitiveneuroectodermaltumors,PNET(原始神經外胚層腫瘤)特色是在腫瘤細胞中央是一塊均質的區域)]4.S/S:IICP(i.e.,headache,nausea,vomiting,mentalstatuschanges,andhypertension)andcerebellardysfunction(i.e.,ataxia,poorbalance,dysmetria).5. Standardclinicalstagingevaluation:MRIofthebrainandspine,bothpreoperativelyandpostoperatively;lumbarpunctureaftertheIICPhasresolved.6. TheChangstagingsystem,originallybasedonsurgicalinformation,hasbeenmodifiedtoincorporateinformationfromneuroimagingtoidentifyriskcategories.7.Prognosticsignificance:includeageatdiagnosis,extentofdisease,andextentofsurgicalresection;(1)patientsyoungerthan4yrofage:apooroutcome,partlyastheresultofahigherincidenceofdisseminateddisease;(2)patientswithdisseminateddi