Extraneural Metastasis of a Nongerminomatous Germ Cell Tumor of the Central Nervous System in a Pediatric Patient With a Ventriculoperitoneal Shunt

Belongia, Meghan; Jogal, Sachin

doi:10.1097/mph.0b013e31823dd370

Cited by 13 publications

(8 citation statements)

References 20 publications

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“…Our case report and review of the literature revealed 28 cases 1–22 of central nervous system tumors demonstrating evidence of extraneural spread associated with VPS in children. In patients of widely varying ages and similar gender distributions a wide variety of tumors were reported, with medulloblastomas and pineal tumors cited most commonly.…”

Section: Discussionmentioning

confidence: 76%

Extracranial, peritoneal seeding of primary malignant brain tumors through ventriculo-peritoneal shunts in children: Case report and review of the literature

2015

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Section: Discussionmentioning

confidence: 76%

Extracranial, peritoneal seeding of primary malignant brain tumors through ventriculo-peritoneal shunts in children: Case report and review of the literature

2015

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“…Thirty-eight articles with a total of 43 patients were reviewed [ Table 1 ]. [ 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 ] The mean age of patients was 15 years and 3 months, with 69.8% (30 out of 43) of the patients in the pediatric age group (<18 years of age), and 67.4% male (29 out of 43). The overall predominant histological subtypes of primary CNS tumors with VPS-related metastasis were germinomas (11 out of 43, 25.6%) and medulloblastomas (5 out of 43, 11.6%).…”

Section: Discussionmentioning

confidence: 99%

Widespread intra-abdominal carcinomatosis from a rhabdoid meningioma after placement of a ventriculoperitoneal shunt: A case report and review of the literature

Jie¹,

Teo

Shabbir

et al. 2018

Asian J Neurosurg

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Intra-abdominal metastasis (IAM) of central nervous system (CNS) tumors via ventriculoperitoneal shunt (VPS) is rare but has been previously reported (e.g., germinomas and medulloblastomas). However, there has been no previous report in the literature involving meningiomas. A case of primary rhabdoid meningioma with widespread intra-abdominal carcinomatosis after placement of a VPS in a 36-year-old man is described. The patient underwent preoperative angioembolization of the tumor, craniotomy, and surgical excision, followed by postoperative gamma knife radiosurgery. Five months later, he underwent a decompressive craniectomy and surgical excision for tumor recurrence causing raised intracranial pressure and communicating hydrocephalus, necessitating placement of a VPS. One month after placement of the VPS, the patient developed abdominal distension and confusion. He was treated for a VPS infection, and the shunt was explanted. He continued to deteriorate with high output from the peritoneal drain placed at the time of shunt explantation. An exploratory laparotomy revealed multiple diffuse peritoneal and omental nodules which had the same histopathological and immunohistochemical morphology as the primary tumor. We reviewed the current literature on IAM of primary CNS tumors via VPS, which revealed that patients belonging in the pediatric age group, of the male gender, and with a primary intracranial germinoma or medulloblastoma have a higher incidence of IAM. Majority of IAM occurred within 2 years of VPS placement, and patients most commonly present with abdominal distension and ascites. Treatment after diagnosis is varied and the prognosis is poor, with more than half of the patients dying within a year. It is vital for clinicians to maintain a high index of suspicion for similar patients, as early intervention could potentially improve patient outcomes and patient expectations managed more effectively.

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“…Only 10 patients developed EIM, 2 of whom were diagnosed with GCTs, 6 with neural tube cell tumors, 1 with ependymoma, and 1 with an atypical rod-shaped tumor. Another study by Belongia and Jogal [ 7 , 8 ] reported that only 0.98% of patients with primary intracranial tumors developed EIM. In addition, Kun et al [ 9 ] recently reported 2 cases of pineal tumors.…”

Section: Discussionmentioning

confidence: 99%

The external metastasis of the central nerve system germ cell tumors: case report and review of the literature

Wang

Qiu

2021

Chin Neurosurg Jl

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Background Central nervous system germ cell tumors (CNS GCTs) represent a class of rare tumors that exhibit region-specific prevalence in some Asian areas (15.3%), higher than that in North America (3.6%), and age-specific prevalence in children and adolescents. According to the 2016 World Health Organization (WHO) classification, CNS GCTs can be categorized into germinomas and non-germinomatous GCTs (NGGCTs). Owing to the compression of the interventricular foramen by enlarged GCTs in the pineal gland, the resultant obstructive hydrocephalus may result in high intracranial pressure (HIP) at an alarming pace, which urgently requires a ventriculoperitoneal shunt for the relief of severe HIP. Although CNS GCT cells tend to migrate through the cerebrospinal fluid (CSF) starting from the subependymal lining, metastasis along the ventriculoperitoneal shunt tube is extremely rare. Case presentation In this study, we reported two cases of iGCTs with intraperitoneal metastasis. Both patients underwent ventriculoperitoneal shunt placement to alleviate HIP, and both received standard radiotherapy and chemotherapy, but they still developed abdominal metastasis, and all the abdominal masses were pathologically confirmed to be iGCTs. Conclusions We performed a literature study and found that from 1979 to 2020, a total of 18 cases of iGCTs were metastasized outside the nervous system. We also found a shift of the median of 13.5 months and that the most common primary site was the pineal region (83.3%); moreover, nearly half of the patients (44%) died within 1 year of metastasis, indicating a poor prognosis after celiac metastasis.

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Extraneural Metastasis of a Nongerminomatous Germ Cell Tumor of the Central Nervous System in a Pediatric Patient With a Ventriculoperitoneal Shunt

Cited by 13 publications

References 20 publications

Extracranial, peritoneal seeding of primary malignant brain tumors through ventriculo-peritoneal shunts in children: Case report and review of the literature

Extracranial, peritoneal seeding of primary malignant brain tumors through ventriculo-peritoneal shunts in children: Case report and review of the literature

Widespread intra-abdominal carcinomatosis from a rhabdoid meningioma after placement of a ventriculoperitoneal shunt: A case report and review of the literature

The external metastasis of the central nerve system germ cell tumors: case report and review of the literature

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