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Medulloblastoma — RACP Paediatrics MCQ

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ModerateNeurology & DevelopmentMedulloblastomaRACP Paediatrics

A 2-year-old presents with a stiff, broad-based gait. He has nystagmus and difficulty sitting unsupported. MRI brain shows a large posterior fossa tumour filling the fourth ventricle with obstructive hydrocephalus. The tumour enhances uniformly. CSF cytology shows malignant cells. What is the most likely diagnosis?

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Correct answer: C — Medulloblastoma

Medulloblastoma is the most common malignant brain tumour in children. It arises from the cerebellum/fourth ventricle and commonly presents with signs of raised ICP and cerebellar dysfunction. It has a propensity for CSF dissemination (drop metastases). Treatment involves maximal safe resection, craniospinal irradiation (in children >3 years), and chemotherapy.

Reference: ANZCHOG – 2024 – Treatment Guidelines: CNS Tumours