Shunt-related Abdominal Metastasis of Cerebral Teratocarcinoma: Report of an Unusual Case and Review of the Literature
- 1 June 1998
- journal article
- case report
- Published by Wolters Kluwer Health in Neurosurgery
- Vol. 42 (6), 1378-1382
- https://doi.org/10.1097/00006123-199806000-00118
Abstract
Internal drainage of cerebrospinal fluid to the abdominal cavity via a ventriculoperitoneal shunt (VPS) is a common procedure for therapy of obstructive hydrocephalus; because this condition is often caused by brain tumors blocking the natural cerebrospinal fluid pathways, the VPS as an artificial anastomosis can provide the means for the spreading of tumor cells by the cerebrospinal fluid. We report the case of a VPS-related abdominal metastasis of a teratocarcinoma and review the pertaining literature. A 24-year-old man with a history of three brain tumors that were operated on when the patient was 14, 21, and 23 years of age developed an acute ileus 7 months after VPS insertion for cerebral teratocarcinoma. Intraoperatively, a massive abdominal tumor was observed, which turned out to be a peritoneal metastasis of the aforesaid brain tumor. The patient died as a result of his illness 1 month later. To date, 58 VPS-related metastases of brain tumors have been described. The male-to-female ratio is 1.6:1, the mean age at shunt insertion is 12.2 years, and the interval between shunt operation and diagnosis of metastases is 16.8 months. During the observation time, 69.2% of the patients died as a result of their illness or abdominal metastases. The most common sources of the metastases were germinomas (27.7%), medulloblastomas (19.1%), and endodermal sinus tumors (10.3%). The presented case is only the second VPS-related abdominal spreading of a cerebral teratocarcinoma. Metastases via VPS are rare but should be considered as a possible complication and mode of systemic spread in patients with primary intracranial malignancy.Keywords
This publication has 36 references indexed in Scilit:
- Peritoneal implantation of meningeal melanosis via ventriculoperitoneal shunt: A case report and review of the literatureDiagnostic Cytopathology, 1995
- Metastatic pineoblastoma via a ventriculoperitoneal shunt: CT demonstrationComputerized Medical Imaging and Graphics, 1992
- The risks of metastases from shunting in children with primary central nervous system tumorsJournal of Neurosurgery, 1991
- Intracranial Germ Cell TumorsJournal of Neuropathology and Experimental Neurology, 1985
- CSF shunt complications: an analysis of contributory factorsChild's Nervous System, 1985
- Endodermal sinus tumor of the pineal region. Metastases through a ventriculoperitoneal shuntCancer, 1984
- Ventriculoperitoneal shunt metastasis of a pineal germinomaComputerized Radiology, 1984
- Extracranial metastases in childhood primary intracranial tumors. A report of 21 cases and review of the literatureCancer, 1984
- Ventriculo-Peritoneal Shunts in the Management of HydrocephalusJournal of Neurosurgery, 1967
- Medulloblastomas and Cerebellar SarcomasJournal of Neurosurgery, 1963