Relapsed High-Risk Medulloblastoma: Stable Disease after Two Years of Treatment with Somatostatin Analog - Case Report

Luisa Galvis, Diego Gonzalez, Carlos Bonilla, Luisa Galvis, Diego Gonzalez, Carlos Bonilla

Abstract

Cerebellar medulloblastoma in adults is an uncommon disease. Therefore, most information comes from the pediatric population, and the treatment for relapses is based on series and case reports. The expression of somatostatin receptors has been identified in most medulloblastoma patients, and preclinical experience has shown a promissory response to somatostatin analogs. This report presents a female patient with a high-risk left cerebellar medulloblastoma diagnosed at age 16 years old who was treated with complete resection, cranial-spinal radiotherapy, and chemotherapy. She presented again at 18 years of age with a sustained progression of her tumor, despite radiosurgery and another line of chemotherapy. Octreotide scintigraphy at that time showed a moderate to high expression of somatostatin receptors; thus, the patient was started on monthly octreotide. She is now 20 and has achieved stable disease over more than two years of active treatment without any drug-related toxicity. Somatostatin analogs could be considered as a treatment option in selected cases of medulloblastoma. Review of the literature is presented for this unusual response.

Keywords: medulloblastoma; octreotide; somatostatin.

Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Figure 1. Postoperative magnetic resonance imaging (MRI)…
Figure 1. Postoperative magnetic resonance imaging (MRI) in February 2011
Left: Axial view Right: Sagittal view
Figure 2. Magnetic resonance imaging (MRI) showing…
Figure 2. Magnetic resonance imaging (MRI) showing cerebellar vermis progression in November 2012
Left: Axial view Right: Sagittal view
Figure 3. In-111 DTPA octreotide scintigraphy in…
Figure 3. In-111 DTPA octreotide scintigraphy in March 2013 showing moderate expression of somatostatin receptors
Left: 4 hours after infusion Right: 24 hours after infusion
Figure 4. Stable disease in magnetic resonance…
Figure 4. Stable disease in magnetic resonance imaging (MRI) during octreotide treatment
Left (Top and Bottom): Axial and sagittal view in February 2014 Right (Top and Bottom): Axial and sagittal view in May 2015

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Source: PubMed

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