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Medical Neuro-Oncology |
Divisions of Gynecologic Oncology (P.M.M., W.A.C.), Neurologic Surgery (J.A.F.), and Medical Oncology (R.D.R, J.C.B.), Mayo Clinic Rochester, Mayo Foundation, Rochester, MN 55905, USA
1 Address correspondence to Paul M. Magtibay, Division of Gynecologic Oncology, Department of Obstetrics/Gynecology, Mayo Graduate School of Medicine, Mayo Clinic, Rochester, MN 55905, USA (magtibay.paul{at}mayo.edu).
Abstract
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.
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