RADIOTHERAPY IN ADULT MEDULLOBLASTOMA WITH SYNCHRONOUS DROP METASTASIS: A CASE REPORT

Background: Adult medulloblastoma is a rare, fast-growing cancerous tumor, and synchronous spinal metastasis at diagnosis represents an uncommon and high-risk presentation. Evidence guiding management in adults remains limited, with most therapeutic strategies extrapolated from pediatric protocols.

Case presentation: We report the case of a 24-year-old patient with medulloblastoma presenting with neuraxial dissemination at initial staging. Magnetic resonance imaging confirmed a posterior fossa mass with synchronous spinal drop metastasis.

Treatment and outcome: The patient underwent a multimodal therapeutic approach centered on craniospinal irradiation. Radiotherapy was delivered to the entire neuraxis followed by targeted boosts to sites of macroscopic disease, using conformal techniques to ensure adequate coverage while respecting organ-at-risk constraints. Treatment was well tolerated and resulted in sustained complete remission at follow-up.