• J Clayton, M Vloeberghs, T Jaspan, D Walker, D MacArthur, and R Grundy.
• Queens Medical Centre, Department of Neurosurgery, University Hospital, Nottingham, UK. julietclayton@hotmail.com
• Acta Neurochir (Wien). 2008 Jul 1; 150 (7): 709-12.

BackgroundMedulloblastoma is the most common malignant brain tumour in children. Despite recent advances, the prognosis in high risk patients remains poor. Further improvement in survival is dependent upon the development of strategies to attack the tumour more effectively, but with less toxicity. Intrathecal chemotherapy, is an ideal but currently underused method of directly targeting residual tumour within the area of resection and the leptomeningeal disease commonly associated with this tumour.MethodWe describe the case of a 12 yr old child with metastatic medulloblastoma, who received intrathecal topotecan via a spinal catheter.ConclusionThis method represents a simple, safe and effective method of delivering an even and widespread distribution of drug within the cerebrospinal fluid (CSF) of the neuroaxis. With new agents being identified and others in the early stages of development, intrathecal chemotherapy may emerge as an important therapeutic option to consider when faced with such challenging cases.

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