St Jeor Jeffery D, Thacker Paul G, Benson John C, Hull Nathan C
Mayo Clinic School of Medicine, 200 1st St SW, Rochester, MN 55902, USA.
Department of Radiology, Mayo Clinic, 200 1st St SW, Rochester, MN 55902, USA.
Radiol Case Rep. 2020 Apr 5;15(6):650-654. doi: 10.1016/j.radcr.2020.02.036. eCollection 2020 Jun.
Ependymomas are rare glial tumors that comprise 10% of intracranial pediatric malignancies. Primary central nervous system malignancies can rarely metastasize extracranially. When metastases occur, it usually does so in the setting of surgical manipulation of the central nervous system and can spread through the blood, lymph, or artificial means, for example, a ventriculoperitoneal shunt. We describe the presentation and progression of an 18-month-old boy diagnosed with an ependymoma. Initially managed with surgery, radiation, and ventriculoperitoneal shunt placement for symptomatic hydrocephalus, the tumor later recurred with drop metastasis to the thoracic spinal cord. The patient subsequently developed extensive metastases within the abdominal cavity, which were seeded through a ventriculoperitoneal shunt. We present a case of a rare complication of intra-abdominal tumor seeding and carcinomatosis from an intracranial ependymoma through a ventriculoperitoneal shunt. This is a rare presentation of a possible complication, which requires awareness of both surgeons and radiologists.
室管膜瘤是罕见的神经胶质瘤，占儿童颅内恶性肿瘤的10%。原发性中枢神经系统恶性肿瘤很少发生颅外转移。当发生转移时，通常是在中枢神经系统手术操作的情况下，可通过血液、淋巴或人工途径扩散，例如脑室腹腔分流术。我们描述了一名18个月大被诊断为室管膜瘤男孩的临床表现和病情进展。最初通过手术、放疗以及因症状性脑积水而进行脑室腹腔分流术进行治疗，后来肿瘤复发并发生播散性转移至胸段脊髓。该患者随后在腹腔内出现广泛转移，是通过脑室腹腔分流术种植的。我们报告了一例罕见的并发症，即颅内室管膜瘤通过脑室腹腔分流术导致腹腔内肿瘤种植和癌病。这是一种可能并发症的罕见表现，需要外科医生和放射科医生都有所认识。
