A LONG SURVIVING CASE OF RECURRENT MEDULLOBLASTOMA DISPLAYING EFFECTIVENESS OF ACNU VINCRISTINE CHEMOTHERAPY/

A favorable case of recurrent medulloblastoma, in which 19 years has e lapsed with combination therapy due to surgery, radiation and chemothe rapy since the initial operation, is reported. The case was a male of age 12 who was admitted due to medulloblastoma of the classical type. Tumor recurrences were observed 3 times within 7 years after the initi al operation and radiation treatment. At the 3rd recurrence, a large t umor was found in the cerebellar vermis and left cerebellar hemisphere on CT with CSF dissemination and a high NSE level in the CSF (62 ng/m l). Only chemotherapy by intravenous administration of 2 courses of 12 0-150 mg ACNU (1.7-2.2 mg/kg) and 4 mg vincristine (0.06 mg/kg) with i ntrathecal administration of methotrexate was given at this time. The tumor image and gait disturbance with radicular pain disappeared compl etely and the NSE level in the CSF improved to within the normal range (5.4 ng/ml). The patient continues in complete remission, with a Karn ovsky performance status of 100% at 4 years after the 3rd recurrence. We report full details of this case in which active treatments consist ing mainly of chemotherapy proved to be effective for recurrent medull oblastoma, even though its prognosis is generally very unfavorable.