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:

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

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

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

Physical findings: Individuals with a medulloblastoma may present with:

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

• Nausea or vomiting in the morning;

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

• Tiredness/Fatigue;

• Tilting the head to one side;

• Double vision (diplopia);

• Rapid, jerky eye movements (nystagmus);

• Facial weakness;

• Ringing in the ears (tinnitus);

• Hearing loss;

• Stiff neck;

• Back pain; and

• 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:

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

• Pathology/biopsy report of the cancer;

• 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

• 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.