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Medulloblastoma — RACP Paediatrics MCQ

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ModerateNeurologyMedulloblastomaRACP Paediatrics

A 5-year-old presents with progressive morning headaches, vomiting, and unsteady gait over 6 weeks. Examination reveals truncal ataxia, papilloedema, and bilateral 6th nerve palsies. MRI shows a midline posterior fossa mass arising from the cerebellar vermis with obstructive hydrocephalus. What is the most likely tumour?

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Correct answer: A — Posterior fossa tumour (medulloblastoma)

A midline posterior fossa mass arising from the cerebellar vermis in a child aged 3-8 years with truncal ataxia and signs of raised ICP (headache, vomiting, papilloedema, CN VI palsies) is most likely medulloblastoma, the most common malignant brain tumour of childhood. It is an embryonal tumour requiring surgical resection, craniospinal irradiation, and chemotherapy.

Reference: RCH Melbourne – 2023 – Brain Tumour CPG; RACP Paediatric Curriculum – Oncology