Disclosures: Sean M. Silverman, DO:

Case Description: Patient had intractable headaches for 1 year with progression of symptoms to include nausea and vomiting. Initial CT showed obstructing fourth ventricular/cerebellar mass, with resulting hydrocephalus and ventriculomegaly. Patient underwent suboccipital craniotomy. Pathology showed medulloblastoma (non-WNT, non-SHH, TP53 wildtype) WHO grade IV. Neuro-oncology was consulted to assist in the management of this patient’s oncological workup and treatment. MRI of the neuroaxis showed no spread. Significant functional deficits include urinary retention, left sided ataxia, and left CN VI palsy with diplopia.

Setting: Acute inpatient rehabilitation unit, tertiary care academic center

Patient: 24 year old man with past medical history significant for anxiety and depression Assessment/

Results: Initial functional status on admission to acute inpatient rehabilitation pertinent for requiring moderate assist in bathing, LE dressing, toileting, transfers and required minimum assist with RW for ambulation of 15 feet. After 10 days, patient was discharged home under the care of his parents. His outpatient rehab program focused on balance to compensate for impaired left-sided proprioception and motor control. Eight weeks after discharge, the patient was walking unsupported at a contact guard assist level. He has completed radiation therapy with plans to begin chemotherapy in the coming weeks.

Discussion: Medulloblastoma is a common pediatric malignancy, comprising 10% of childhood brain tumors (Millard NE et al 2016) but is far less common in adults, with an incidence rate of 0.5 per one million (Giordana MT et al 1999). There is emerging data regarding surgical, chemotherapy, and radiation therapy in regards to treatment, but there is not much information about the functional recovery post treatment for medulloblastoma in adults.

Conclusion: This case report shows promising functional recovery of an adult post surgical resection of a medulloblastoma. Initial deficits included diplopia and ataxia. Patient required a moderate assist in most functional domains, but around 10 weeks post surgery was able to function modified independently.

Level of Evidence: Level V

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PM&R Meeting Abstracts - https://pmrjabstracts.org/abstract/medulloblastoma-in-an-adult-a-case-report/