MEDULLOBLASTOMA

Medulloblastoma is a rare type of malignant brain cancer that occurs in the cerebellum and adjacent tissue (which control body movement and coordination). Medulloblastomas are primarily a type of childhood brain cancer, and rarely occur in adults.

Diagnostic testing: The diagnosis of a medulloblastoma is made by:

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  Imaging tests including MRI of the brain and spine; CT, PET scan, and radionuclide bone scans;

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  A spinal tap may be performed to obtain cerebral spinal fluid to search for cancer cells or tumor markers; and

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  Analysis of the tumor after surgical resection confirms the diagnosis of medulloblastoma.

Physical findings: Individuals with a medulloblastoma may present with:

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  Headaches which are often worse in the morning and get better during the day;

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  Nausea or vomiting in the morning;

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  Problems with motor skills, such as clumsiness or poor handwriting;

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  Tiredness/Fatigue;

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  Tilting the head to one side;

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  Double vision (diplopia);

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  Rapid, jerky eye movements (nystagmus);

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  Facial weakness;

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  Ringing in the ears (tinnitus);

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  Hearing loss;

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  Stiff neck;

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  Back pain; and

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  Inability to control bladder and bowel functions.

ICD-9: 191.6

Prognosis is poor for medulloblastoma.

Surgery alone does not cure this type of cancer. Chemotherapy and radiation are often used in combination with surgery.

SUGGESTED PROGRAMMATIC ASSESSMENT*

Suggested MER for Evaluation:

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  Clinical history and examination that describes the diagnostic features of the impairment;

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  Pathology/biopsy report of the cancer;

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  If a pathology report is unavailable, a surgical report or all radiological studies (for example, MRI and CT scans) and treatment notes indicating antineoplastic therapy for metastases may be substituted; and

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  If available, spinal tap results.

Suggested Listings for Evaluation:

REMARKS

Medulloblastoma meets the criteria in listing 13.13 A 2 upon confirmed diagnosis, regardless of the effectiveness of treatment.