Published: 2020-05-22

Persistent vomiting, an alarm sign in children

Ramya G., Arul Kumaran A., Tanay Gupta


Brain tumors, the second common cancer following hematological malignancies account for up to 21% of all malignancies below 14 years of age. Medulloblastoma is a common form of Primitive neuro ectodermal tumor and likely arise from either the external granular layer (e.g., desmoplastic variant) or the subependymal matrix cells of the fourth ventricle (e.g., classic variant), or both. The clinical course of the disease is aggressive in children than in adults. The tumor can invade the CSF through the ventricles or even cause metastases to bones and lymph node. With the emergence of advanced technologies and treatment facilities, the morbidity and mortality of the disease is greatly improved with a five-year survival of up to 75%. However, the presence of disease in children <3 years or evidence of dissemination on diagnosis carries poor prognosis. Here we are discussing a case of 5-year-old girl who presented to OPD with vomiting for 1 month.


Medulloblastoma, Persistent vomiting, Primitive neuro ectodermal tumor

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Das U, Appaji L, Kumari BA, Sirsath NT, Padma M, Kavitha S, et al. Spectrum of pediatric brain tumors: a report of 341 cases from a tertiary cancer center in India. Ind J Pediatr. 2014 Oct 1;81(10):1089-91

Strother DR, Pollack IF, Fisher PG, Hunter JV, Woo SY, Pomeroy SL, et al. Tumors of the central nervous system. In: Pizzo PA, Poplack DG, eds. Principles and Practice of Pediatric Oncology. 4th ed. Philadelphia: Lippincott Williams and Wilkins; 2002: 751-824.

Gaur S, Kumar SS, Balasubramaniam P. An analysis of medulloblastoma: 10 year experience of a referral institution in South India. Ind J Cancer. 2015 Oct 1;52(4):575

Rutkowski S, Von Hoff K, Emser A, Zwiener I, Pietsch T, Figarella-Branger D, et al. Survival and prognostic factors of early childhood medulloblastoma: an international meta-analysis. J Clini Oncol. 2010 Oct 12;28(33):4961-8

McNeil DE, Coté TR, Clegg L, Rorke LB. Incidence and trends in pediatric malignancies medulloblastoma/primitiveneuroectodermal tumor: a SEER update. Surveill Epidemiology and EndResults. Med Pediatr Oncol. 2002;39:190

Rickert CH, Paulus W. Epidemiology of central nervous system tumors in childhood and adolescence based on the new WHO classification. Childs Nerv Syst. 2001;17:503-11.

Jain A, Sharma MC, Suri V, Kale SS, Mahapatra AK, Tatke M, et al. Spectrum of pediatric brain tumors in India: A multi-institutional study. Neurol India. 2011;59:208-11.

Sasai K, Romer JT, Kimura H, Eberhart DE, Rice DS, Curran T. Medulloblastomas derived from Cxcr6 mutant mice respond to treatment with a smoothened inhibitor. Cancer Res. 2007 Apr 15;67(8):3871-7.

Kool M, Koster J, Bunt J, Hasselt NE, Lakeman A, Van Sluis P, et al. Integrated genomics identifies five medulloblastoma subtypes with distinct genetic profiles, pathway signatures and clinicopathological features. PloS One. 2008;3(8).