Chang et al developed a staging scheme for patients with medulloblastoma. This can be used to describe the extent of disease. The authors are Columbia University and the Columbia-Presbyterian Medical Center in New York City.
Parameters:
(1) T stage
(2) M stage
NOTE: There is no N stage since medulloblastomas do not usually involve lymph nodes.
Direct Extension |
T Stage |
diameter < 3.0 cm and limited to midline position (vermis, roof of the 4th ventricle, or cerebellar hemispheres) |
T1 |
diameter >= 3.0 cm and invading 1 adjacent structure |
T2 |
diameter >= 3.0 cm and partially filling the 4th ventricle |
T2 |
tumor invading 2 adjacent structures |
T3a |
tumor completely filling the 4th ventricle with extension into the aqueduct of Sylvius, foramen of Magendie or foramen of Luschka, with internal hydrocephalus |
T3a |
tumor arising from the floor of the 4th ventricle and completely filling the 4th ventricle |
T3b |
tumor arising from brainstem and completely filling the 4th ventricle |
T3b |
tumor spread through the aqueduct of Sylvius to involve the 3rd ventricle and/or midbrain |
T4 |
tumor spread down into upper cervical cord |
T4 |
Metastasis |
M Stage |
none |
M0 |
microscopic tumor cells seen in CSF, no gross tumor |
M1 |
gross nodular seeding in cerebellum, cerebral subarachnoid space, in the third ventricle or in the fourth ventricle |
M2 |
gross nodular seeding in spinal subarachnoid space |
M3 |
metastasis extraneuraxial (hematogenous spread) |
M4 |
Specialty: Hematology Oncology, Surgery, general, Neurology