Isolated complete oculomotor nerve palsy as a presentation of adult medulloblastoma

• References

A 37-year-old man presented with isolated complete oculomotor nerve palsy, without other neurological signs. Magnetic resonance imaging (MRI) showed thickening and enhancement of the left third cranial nerve, along with a small nodular lesion in the right cerebellar hemisphere with diffusion restriction ([Figure 1]). Repeated cerebrospinal fluid analysis eventually confirmed the presence of neoplastic cells. Resection of the cerebellar lesion revealed desmoplastic/nodular-type medulloblastoma (MB), sonic hedgehog (SHH)-activated, and TP53 wildtype. The patient was treated with neuroaxis radiotherapy and adjuvant chemotherapy. This case demonstrates a rare presentation of adult MB, highlighting the importance of considering leptomeningeal dissemination in the differential diagnosis of isolated cranial neuropathies.[1] [2] [3] [4]

Conflict of Interest

There is no conflict of interest to declare.

Authors Contributions

Conceptualization: RTNL, BGG, MSC, SBAN, AJS; Data curation: RTNL, BGG, MSC, SBAN, AJS; Formal analysis: RTNL, BGG, MSC, SBAN, AJS; Validation: RTNL, BGG, MSC, SBAN, AJS; Visualization: RTNL, BGG, MSC, SBAN, AJS; Writing – original draft: RTNL, BGG, MSC, SBAN, AJS; Writing – review & editing: RTNL, BGG, MSC, SBAN, AJS; Investigation: RTNL, BGG, MSC, SBAN, AJS; Project administration: RTNL, BGG, MSC, SBAN, AJS; Resources: RTNL, BGG, MSC, SBAN, AJS; Visualization: RTNL, BGG, MSC, SBAN, AJS; Funding acquisition: MSC; Supervision: MSC.

Data Availability Statement

This study is a case report and, therefore, did not generate or analyze any dataset beyond the information included in the manuscript. Additional patient data (such as images or test results) are available upon request to the corresponding author, subject to ethical approval and patient consent.

Editor-in-Chief: Hélio A. G. Teive 0000-0003-2305-1073.

Associate Editor: Leandro Tavares Lucato 0000-0001-9181-5245.

• References

• 1 Majd NK, Mastall M, Lin H, Dibaj SS, Hess KR, Yuan Y. et al. Clinical characterization of adult medulloblastoma and the effect of first-line therapies on outcome; The MD Anderson Cancer Center experience. Neurooncol Adv 2021; 3 (01) vdab079
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• 2 Cocito C, Martin B, Giantini-Larsen AM, Valcarce-Aspegren M, Souweidane MM, Szalontay L. et al. Leptomeningeal dissemination in pediatric brain tumors. Neoplasia 2023; 39: 100898
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• 3 Russo C, Scala MR, Spennato P, Nastro A, Errico ME, De Martino L, Cinalli G. Primary leptomeningeal medulloblastoma: a case-based review. Childs Nerv Syst 2022; 38 (03) 527-536
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• 4 Zhao F, Li C, Zhou Q, Qu P, Wang B, Wang X. et al. Distinctive localization and MRI features correlate of molecular subgroups in adult medulloblastoma. J Neurooncol 2017; 135 (02) 353-360
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Address for correspondence

Publication History

Received: 18 March 2025

Accepted: 17 April 2025

Article published online:
01 July 2025

© 2025. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution 4.0 International License, permitting copying and reproduction so long as the original work is given appropriate credit (https://creativecommons.org/licenses/by/4.0/)

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• References

• 1 Majd NK, Mastall M, Lin H, Dibaj SS, Hess KR, Yuan Y. et al. Clinical characterization of adult medulloblastoma and the effect of first-line therapies on outcome; The MD Anderson Cancer Center experience. Neurooncol Adv 2021; 3 (01) vdab079
  Search in Google Scholar
• 2 Cocito C, Martin B, Giantini-Larsen AM, Valcarce-Aspegren M, Souweidane MM, Szalontay L. et al. Leptomeningeal dissemination in pediatric brain tumors. Neoplasia 2023; 39: 100898
  Search in Google Scholar
• 3 Russo C, Scala MR, Spennato P, Nastro A, Errico ME, De Martino L, Cinalli G. Primary leptomeningeal medulloblastoma: a case-based review. Childs Nerv Syst 2022; 38 (03) 527-536
  Search in Google Scholar
• 4 Zhao F, Li C, Zhou Q, Qu P, Wang B, Wang X. et al. Distinctive localization and MRI features correlate of molecular subgroups in adult medulloblastoma. J Neurooncol 2017; 135 (02) 353-360
  Search in Google Scholar