RARE CASE MEDULLOBLASTOMA WITH MANDIBULAR SECONDARY

Aim to report a rare case of medulloblastoma with mandibular secondaries.Background Medulloblastoma is an embryonal tumor, common in children. It has a high malignant potential with a propensity to spread to lymphatic organs and bone, mostly vertebrae, but mandible involvement is very rare. Case History A 10 year old male child was diagnosed with cerebellar medulloblastoma , with spinal involvement at D5 vertebral level, in 2010, for which he was treated with near total excision followed by CSI 36 Gy, with posterior fossa boost up to 54 Gy. He received 6 cycles of cisplatin and etoposide, after which there was complete remission. After being disease free on subsequent follow up, he reported again with a swelling of the jaw in 2013, which was proved to be as secondaries from medulloblastoma. He was treated with radiotherapy to a dose of 46 Gy to the mandibular swelling. There was a partial response in the lesion. The patient was put on salvage chemotherapy then using vincristine and cyclophosphamide.Conclusion Medulloblastoma metastasizing to the mandible is a rare event. Radiotherapy to the osseous secondary was not found to completely resolve it. However, with the use of second line chemotherapy, more successful treatment might be possible but the outcome is generally poor.