Surgery for Medulloblastoma

Surgery is typically the first line of treatment for medulloblastoma. You may hear it referred to as “surgical resection.”

The goal of surgery is to remove as much of the tumor as possible. In general, the more of the tumor that is removed, the better the prognosis.

During the surgery, the neurosurgeon will also obtain a tissue sample of the tumor so that the subtype of medulloblastoma can be determined.

How Is Surgery for Medulloblastoma Performed?

To perform the operation, the neurosurgeon first removes a piece of the skull bone to gain access to the tumor. This is called a craniotomy. The neurosurgeon will then remove, or resect, as much of the tumor as possible.

After the tumor has been removed, the cerebrospinal fluid (CSF) can once again flow normally. This often resolves any hydrocephalus.

There are some cases where removing the entire tumor is not possible because of where it is located. If there is any tumor left over after surgery, your doctors may need to intensify radiation or chemotherapy.

If the tumor cannot be removed at all, it is called inoperable and will be treated with radiation and/or chemotherapy.  If resection is not feasible,  a biopsy will likely be performed to determine diagnosis and subtype.

What to Expect After Surgery for Medulloblastoma

Once the brain tumor is removed, hydrocephalus and its related symptoms often go away. If that is not the case, a shunt or ventriculostomy might be recommended to drain cerebrospinal fluid buildup.

Some children develop posterior fossa syndrome after surgery. This occurs in cases when surgery has caused damage to the brain. The damage may be temporary or permanent, and can lead to language difficulties and emotional concerns. Posterior fossa syndrome occurs in about 25%-35% of patients.

Since there is a chance that some cancer cells can remain in the brain after surgery, radiation and/or chemotherapy are typically the next steps in treatment for medulloblastoma.