Unusual presentation of adult metastatic peritoneal medulloblastoma associated with a ventriculoperitoneal shunt: a case study and review of the literature

• Published in: Neuro-oncology (Charlottesville, Va.) Va.), 2003-07, Vol.5 (3), p.217-220
• Main Authors: Magtibay, Paul M, Friedman, Jonathan A, Rao, Ravi D, Buckner, Jan C, Cliby, William A
• Format: Article
• Language: English
• Subjects: Adult; Female; Humans; Medulloblastoma - diagnostic imaging; Medulloblastoma - therapy; Peritoneal Neoplasms - diagnostic imaging; Peritoneal Neoplasms - therapy; Radiography; Ventriculoperitoneal Shunt - adverse effects; Ventriculoperitoneal Shunt - methods
• ISSN: 1522-8517; 1523-5866
• DOI: 10.1215/S115285170200042X

Patients with medulloblastoma uncommonly develop extracerebral metastases. We describe an adult patient with the unusual occurrence of intraperitoneal metastases associated with a ventriculoperitoneal (VP) shunt, as well as her subsequent treatment with high-dose chemotherapy and bone marrow transplantation. We review the literature regarding this rare presentation and association of metastatic spread via VP shunt devices. A 37-year-old woman presented with a rapidly enlarging pelvic mass. She had a history of medulloblastoma and had been treated with a combination of surgery, chemotherapy, and radiation 5 years previously, at which time a VP shunt had been placed for cerebrospinal fluid leakage. At laparotomy, she had unresectable intraperitoneal metastatic medulloblastoma. After an excellent response to cyclophosphamide, etoposide, and cisplatin, she underwent a resection of residual disease, followed by high-dose chemotherapy and a bone marrow transplant. We conclude that adult onset medulloblastoma with metastasis to the peritoneal cavity is rare and may be associated with a VP shunt.