Supratentorial metastases and routes of dissemination of medulloblastoma: Report of two cases

Two children of 4 and 18 years of ages developed multiple supratentorial metastases at 3 years and 8 months follow up respectively, following their gross total microsurgical excision of medulloblastomas. Both the children received standard doses of craniospinal irradiation following surgery. An adjuvant chemotherapy was also offered to the younger child (of 4 years), who developed recurrence at posterior fossa along with supratentorial metastases. It is concluded, that early supratentorial metastases may occur even following gross total excision, craniospinal irradiation and chemotherapy of medulloblastomas. Probable routes of dissemination remain subarachnoid, cerebrospinal fluid and leptomeningeal.