MEDULLOBLASTOMA IN A 16-YEAR-OLD PATIENT: A CLINICAL CASE

Abstract

Relevance: Brain tumors are the most common solid tumors in children, with medulloblastomas accounting for almost 20%. The Electronic Registry of Oncological Patients of the Republic of Kazakhstan (RK) reports 27 morphologically verified cases of medulloblastoma in 2021, 18 of them in children (66.6%). The aim was to show the feasibility of conducting a molecular genetic study to clarify the diagnosis of brain tumors using a clinical case as an example. Methods: The article describes a clinical case of a patient with medulloblastoma. The examinations made included computed tomography of the brain, magnetic resonance imaging of the brain, as well as pathomorphological revision with an immunohistochemical examination of postoperative material. Results: The patient was admitted to the Center of Pediatric Oncology of “Kazakh Institute of Oncology and Radiology” JSC (Almaty, Kazakhstan) with a referral morphological diagnosis of “Ependymoma of the cerebellar vermis with compression of the 4th ventricle. Grade II. Condition – after ventriculoperitoneostomy on the left side (14.11.2021), after microsurgical removal of the tumor (07.12.2021). 2nd clinical group.” Because of the atypical localization of the formation, a pathomorphological review with an immunohistochemical study of the postoperative material was carried out. Conclusion: the morphological picture and immunophenotype correspond to desmoplastic/nodular medulloblastoma, grade IV. ICD-O code 9471/3. The treatment tactics were revised based on morphological data. Conclusion: Medulloblastoma is a highly malignant tumor with an aggressive course. Choosing the right treatment tactics depends on a timely, accurate diagnosis, which makes the diagnosis a key link in the patient management algorithm. This requires conducting a morphological, immunohistochemical examination. According to the 5th version of the 2021 WHO classification of CNS tumors, a molecular genetic study is required to accurately determine the morphological structure of the tumor and achieve a better response to therapy. This necessitates a revision of the relevant clinical guidelines adopted in the Republic of Kazakhstan.