Abstract:
Medulloblastoma is a frequent and aggressive pediatric tumor. It causes intracranial hypertension, necessitating ventriculoperitoneal shunting with surgical resection. Intraperitoneal metastases are rare and result from the migration of neoplastic cells through the shunt and into the peritoneal cavity. This metastatic form involving the ventriculoperitoneal shunt has a poor prognosis, making therapeutic management even more difficult. We report the case of a 14-year-old boy with a history of medulloblastoma of the cerebellum who was initially treated with complete resection of the tumor with placement of a ventriculoperitoneal shunt, followed by radiotherapy and chemotherapy, with good progression until he presented to the emergency department with acute abdominal symptoms. Imaging revealed multiple peritoneal masses with intra- and retroperitoneal lymphadenopathies. An ultrasound-guided biopsy revealed a metastatic medulloblastoma in the peritoneal cavity, and the patient underwent chemotherapy. The placement of the ventriculoperitoneal shunt in the tumor dissemination is therefore to blame.
摘要:
髓母细胞瘤是一种常见的侵袭性儿科肿瘤。会导致颅内高压,需要通过手术切除进行脑室腹膜分流。腹膜内转移很少见,是由于肿瘤细胞通过分流器迁移到腹膜腔中所致。这种涉及脑室-腹腔分流的转移形式预后不良,使治疗管理更加困难。我们报告了一个有小脑髓母细胞瘤病史的14岁男孩的病例,该男孩最初接受了完全切除肿瘤并放置了脑室腹膜分流术的治疗。接下来是放疗和化疗,进展良好,直到他出现急性腹部症状到急诊科。影像学显示多个腹膜肿块伴有腹膜内和腹膜后淋巴结病。超声引导活检显示腹膜腔有转移性髓母细胞瘤,患者接受了化疗。因此,应归咎于脑室-腹膜分流术在肿瘤播散中的放置。