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A Journal on Surgery

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Chirurgia 2012 February;25(1):39-42

language: English

Cerebellar medulloblastoma associated with pineal enhancing mass lesion: case report

Samis Zella M. A. 1, Bertani G. 1, Caroli M. 1, Rampini P. 1, Bauer D. 2, Gaini S. M. 1

1 Neurosurgery Unit, Department of Neurological Sciences, Ospedale Maggiore Policlinico, Mangiagalli e Regina Elena, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico, Milan, Italy
2 Pathology Unit, Department of Medicine, Surgery and Dentistry, Azienda Ospedaliera San Paolo e Fondazione Ospedale Maggiore IRCCS, Milan, Italy


Medulloblastoma is a malignant and invasive embryonal tumour of the cerebellum (WHO grade IV), and it is the most frequent histologic type of malignant brain tumour in childhood (0 to 18 years), representing 16.3% of all pediatric tumor. Cystic lesions within the pineal gland can be of neoplastic or non-neoplastic origin. In this study we report a simultaneous occurrence of medulloblastoma and a benign pineal cyst in the same patient, which has not been reported before.
A 12 years-old girl presented at our Institution with a 4 months history of headache, nausea, vomiting and weight loss. Head CT and MR imaging showed a vermian mass lesion growing into the fourth ventricle highly suggestive for medulloblastoma. A second mass lesion was present in the pineal region. Once considered the age of the patient, the anatomical features of the lesions and their localization, we decided to operate the girl with removal of both the posterior fossa lesion and the pineal one. She was then followed up regurarly after surgery and radiotherapy and made good progress with normal development. We provide a brief review of the literature on incidence and etiology of the two lesions and their simultaneous occurrence.

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