{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T00:05:45Z","timestamp":1789517145781,"version":"build-2803163510"},"reference-count":11,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"11","license":[{"start":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T00:00:00Z","timestamp":1789344000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Neurosurg Case Lessons"],"published-print":{"date-parts":[[2026,9,14]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND<\/jats:title>\n                    <jats:p>Medulloblastomas (MBs) are the most common malignant brain tumor in pediatrics and are associated with several germline risk disorders such as Li Fraumeni, Gorlin, and Turcot syndromes. While most arise idiopathically, inherited cancer syndromes contribute to a minority of cases and have implications in both treatment and surveillance. Despite being the most common mesenchymal tumor of the gastrointestinal tract, gastrointestinal stromal tumors (GISTs) are exceedingly rare in children and do not have a known association with cancer syndromes that predispose one to MB. The authors present a unique pediatric case of concurrent MB and metastatic GIST and raise the question of a possible shared genetic etiology, as there stands no prior report of the two occurring simultaneously within the literature.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>OBSERVATIONS<\/jats:title>\n                    <jats:p>\n                      A 17-year-old female with a history of metastatic GIST was found to have a growing cerebellar lesion on MRI following an emergency department visit for persistent nausea, imbalance, and intermittent headaches. Suboccipital resection revealed a distinct second primary tumor, which was identified as SHH-activated\n                      <jats:italic>TP53<\/jats:italic>\n                      wildtype MB. This case highlights an unusual concurrence of two rare malignancies in a pediatric patient.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>LESSONS<\/jats:title>\n                    <jats:p>This unique presentation of an SHH-activated MB in a pediatric patient with metastatic GIST demonstrates the potential for shared genetic susceptibilities between embryonal and mesenchymal tumors. The authors highlight the importance of germline testing in childhood cases of multiple primary malignancies, especially with SHH-activated MBs to identify possible underlying hereditary cancer syndromes.<\/jats:p>\n                    <jats:p>\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/thejns.org\/doi\/10.3171\/CASE25749\">https:\/\/thejns.org\/doi\/10.3171\/CASE25749<\/jats:ext-link>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/case25749","type":"journal-article","created":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T00:00:50Z","timestamp":1789516850000},"source":"Crossref","is-referenced-by-count":0,"title":["Medulloblastoma in concurrence with metastatic gastrointestinal stromal tumor: what\u2019s the GIST? Illustrative case"],"prefix":"10.3171","volume":"12","author":[{"given":"Jack A.","family":"Leoni","sequence":"first","affiliation":[{"name":"School of Medicine, Louisiana State University Health Sciences Center, New Orleans, Louisiana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jamieson S.","family":"Glasser","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Louisiana State University Health Sciences Center, New Orleans, Louisiana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kelsey N.","family":"Hundley","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Louisiana State University Health Sciences Center, New Orleans, Louisiana"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"3","key":"bib1","series-title":"Brain Pathol","first-page":"664","article-title":"Pathology, diagnostics, and classification of medulloblastoma","volume":"30","author":"Orr","year":"2020","unstructured":"Orr BA.Pathology, diagnostics, and classification of medulloblastoma. Brain Pathol. 2020;30(3):664-678. doi:10.1111\/bpa.12837"},{"issue":"3","key":"bib2","series-title":"Neurooncol Pract","first-page":"138","article-title":"Case-based review: pediatric medulloblastoma","volume":"4","author":"Kline","year":"2017","unstructured":"Kline CNPacker RJHwang EICase-based review: pediatric medulloblastoma. Neurooncol Pract. 2017;4(3):138-150. doi:10.1093\/nop\/npx011"},{"key":"bib3","series-title":"Front Oncol","first-page":"566822","article-title":"Cancer predisposition syndromes and medulloblastoma in the molecular era","volume":"10","author":"Carta","year":"2020","unstructured":"Carta RDel Baldo GMiele ECancer predisposition syndromes and medulloblastoma in the molecular era. Front Oncol. 2020;10:566822. doi:10.3389\/fonc.2020.566822"},{"key":"bib4","article-title":"Gastrointestinal stromal tumors","author":"Burch","year":"2022","unstructured":"Burch JAhmad I.Gastrointestinal stromal tumors. In: StatPearls. StatPearls Publishing; 2022. Accessed July 12, 2026. https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK554541\/"},{"issue":"9","key":"bib5","series-title":"Children","first-page":"1040","article-title":"Gastrointestinal stromal tumors (GISTs) in pediatric patients: a case report and literature review","volume":"11","author":"Popoiu","year":"2024","unstructured":"Popoiu TAP\u00eervu CAPopoiu CMGastrointestinal stromal tumors (GISTs) in pediatric patients: a case report and literature review. Children. 2024;11(9):1040. doi:10.3390\/children11091040"},{"key":"bib6","series-title":"Transl Gastroenterol Hepatol","first-page":"54","article-title":"Pediatric gastrointestinal stromal tumors\u2014a review of diagnostic modalities","volume":"3","author":"Quiroz","year":"2018","unstructured":"Quiroz HJWillobee BASussman MSPediatric gastrointestinal stromal tumors\u2014a review of diagnostic modalities. Transl Gastroenterol Hepatol. 2018;3:54. doi:10.21037\/tgh.2018.07.08"},{"issue":"1","key":"bib7","series-title":"BMC Cancer","first-page":"1119","article-title":"Gastrointestinal stromal tumor with intracranial metastasis: case presentation and systematic review of literature","volume":"19","author":"Prablek","year":"2019","unstructured":"Prablek MSrinivasan VMSrivatsan AGastrointestinal stromal tumor with intracranial metastasis: case presentation and systematic review of literature. BMC Cancer. 2019;19(1):1119. doi:10.1186\/s12885-019-6316-7"},{"issue":"10","key":"bib8","series-title":"J Clin Oncol","first-page":"e122","article-title":"Intracranial metastasis from pediatric GI stromal Tumor","volume":"30","author":"Jagannathan","year":"2012","unstructured":"Jagannathan JPRamaiya NHShinagare ABHornick JLGeorge S.Intracranial metastasis from pediatric GI stromal Tumor. J Clin Oncol. 2012;30(10):e122-e125. doi:10.1200\/JCO.2011.38.1798"},{"issue":"6","key":"bib9","series-title":"Lancet Oncol","first-page":"785","article-title":"Spectrum and prevalence of genetic predisposition in medulloblastoma: a retrospective genetic study and prospective validation in a clinical trial cohort","volume":"19","author":"Waszak","year":"2018","unstructured":"Waszak SMNorthcott PABuchhalter ISpectrum and prevalence of genetic predisposition in medulloblastoma: a retrospective genetic study and prospective validation in a clinical trial cohort. Lancet Oncol. 2018;19(6):785-798. doi:10.1016\/S1470-2045(18)30242-0"},{"issue":"2","key":"bib10","series-title":"Acta Neuropathol","first-page":"231","article-title":"Pediatric and adult sonic hedgehog medulloblastomas are clinically and molecularly distinct","volume":"122","author":"Northcott","year":"2011","unstructured":"Northcott PAHielscher TDubuc APediatric and adult sonic hedgehog medulloblastomas are clinically and molecularly distinct. Acta Neuropathol. 2011;122(2):231-240. doi:10.1007\/s00401-011-0846-7"},{"issue":"1","key":"bib11","series-title":"Cell Commun Signal","first-page":"11","article-title":"A highlight on Sonic hedgehog pathway","volume":"16","author":"Carballo","year":"2018","unstructured":"Carballo GBHonorato JRde Lopes GPSpohr TCLSE.A highlight on Sonic hedgehog pathway. Cell Commun Signal. 2018;16(1):11. doi:10.1186\/s12964-018-0220-7"}],"container-title":["Journal of Neurosurgery: Case Lessons"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-case-lessons\/12\/11\/article-CASE25749.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-case-lessons\/12\/11\/article-CASE25749.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-case-lessons\/12\/11\/article-CASE25749.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T00:00:50Z","timestamp":1789516850000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-case-lessons\/12\/11\/article-CASE25749.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,14]]},"references-count":11,"journal-issue":{"issue":"11"},"URL":"https:\/\/doi.org\/10.3171\/case25749","relation":{},"ISSN":["2694-1902"],"issn-type":[{"value":"2694-1902","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,14]]}}}