Moir J A G, Haugk B, French J J
Department of Hepato-Pancreatic-Biliary Surgery, Freeman Hospital, Newcastle, UK.
Case Rep Gastroenterol. 2010 Aug 2;4(2):267-72. doi: 10.1159/000316118.
Meningiomas are slow-growing intracranial/intraspinal tumours, with a wide range of histopathological variants. The more aggressive atypical and malignant types can disseminate via the venous system, lymphatics or cerebrospinal fluid, with the lungs and pleura being the most common site of extracranial metastasis. We look at a 68-year-old woman presenting with abdominal pain, who had previously been treated for an intracranial meningioma with a ventriculo-peritoneal shunt in situ. Investigation revealed a lesion in segment 4 of the liver with the shunt tip being in close proximity. Biopsy was consistent with metastatic meningioma. A liver resection was subsequently performed. We postulate that this is the first reported case of dissemination of an intracranial meningioma via cerebrospinal fluid by means of a ventriculo-peritoneal shunt.
脑膜瘤是生长缓慢的颅内/脊髓肿瘤，具有多种组织病理学变异类型。侵袭性更强的非典型和恶性类型可通过静脉系统、淋巴管或脑脊液播散，肺和胸膜是颅外转移最常见的部位。我们来看一位68岁出现腹痛的女性，她之前因颅内脑膜瘤接受了脑室-腹腔分流术，分流管仍在位。检查发现肝脏第4段有一个病变，分流管尖端与之紧邻。活检结果符合转移性脑膜瘤。随后进行了肝切除术。我们推测这是首例通过脑室-腹腔分流管经脑脊液播散颅内脑膜瘤的报道病例。
