BACKGROUND. Does a "delay in diagnosis" lead to a child being diagnosed with advanced stage as opposed to early stage medulloblastoma? Correlation between the duration of a patient's presenting symptoms and stage at diagnosis was examined.
METHODS.
The population consisted of 72 consecutive patients with histologically proven medulloblastoma diagnosed between July 1, 1983 and July 31, 1995. A standard history and physical examination format was used to record the nature and duration of presenting symptoms. Patients were staged by use of the operative findings, pre-and postoperative cranial computed tomography ICT) scans and, later in the series, cranial magnetic resonarice imaging (MRI) studies and, for determination of the M stage, myelography, spinal MRI, and postoperative cerebrospinal fluid cytology. RESULTS. There were 40 males (56%) and 32 females (44%) with a mean age of 11.8 years. The most common presenting symptoms were vomiting (67%), headache (60%), ataxia (40%), and nausea (39%). By the Chang-Harisiadis (CH) system, 39 patients (54%) were found to have high stage medulloblastoma (T3b-4MO or any TM1-41, 27 (38%) had low stage disease (T1-3aMO), and in 6 (8%) the stage could not be fully determined. By the Langston modification of the Chang-Harisiadis system (LCH) 38 patients (54%) had high stage, 24 (32%) had low stage, and in 10 (14%) the stage could not be fully determined. Fifty of the 66 patients for whom the duration of symptoms was known (76%) had s 3 months of symptoms