Hallazgos Antropológicos en un Caso de Meduloblastoma

Resumo

Medulloblastoma is a malignant neuroectodermal tumor of the cerebellum. A complete skeleton from an exhumation of a 33 year-old female is available. She deceased 15 years ago in Madrid Community. She was diagnosed with medulloblastoma with vermis affectation. In the skull it appears a suboccipital craniotomy with a resection in the posterior border of foramen magnum, and extending above to the tentorial plane. Also, a parasagittal parietal craniotomy with bone flap replacement can be found, extended to the rightside. In such craniotomy we find the minimal degree of diastasis, and loosened clamping silk sutures can hardly be appreciated. In addition, two frontal post-coronal trepan holes (one on each side) can be identified. All bone removal has advanced marks of remodeling in its borders. It is possible that the three surgical procedures are related with different times of the treatment of a common pathology. It may be possible that the tumor approached through the parietal lobe is due to the treatment of metastases, while the extended parasagittal approach might be related to dural metastases. Suboccipital craniotomy is the common surgical approach to the posterior fossa of the medulloblastoma. Trephinations in the frontal area may be due either to external drainages or to a biventricular derivation (probably ventricular-peritonial), in order to solve the obstruction of the CFS circulation in the posterior fossa level, not uncommon in this pathology. It is possible that the suboccipital and parietal processes correspond to the same surgical time or near in time. Bone regeneration signs show that there was a longtime survival after surgery. Therefore, we may consider that this is a case with three neurosurgical procedures. Probably they correspond to the treatment of medulloblastoma in the cerebellum with a probably dural hemispheric metastasis.