Systemic Metastasis of Brain Tumors via Ventriculoperitoneal Shunt

—Report of Two Cases—

Abstract

Two cases of primary brain tumors with systemic metastasis via ventriculoperitoneal shunt ars reported.
The first case was a 4-year-old girl who developed a generalized tonic-clonic convulsion. She was admitted because of headache, nausea and left hemiparesis. Subtotal removal of the right frontal tumor was performed. A ventriculoperitoneal shunt was carried out on the 11th postoperative day, and then 3, 000 rads of ⁶⁰Co irradiation were given. Five months after the ventriculoperitoneal shunting, abdominal tumors were revealed and she died. Autopsy revealed systemic metastases (peritoneum, liver, GI tract, pancreas and spleen) of the brain tumor via the shunt tube. Microscopical diagnosis was ependymoma.
The second patient, a 59-year-old female, was admitted because of severe frontal signs. Subtotal removal of the right frontal tumor was carried out and 6, 000 rads were irradiated by ¹¹Co postoperatively. A ventriculoperitoneal shunt was performed four months postoperatively. Nine months after the shunting operation, an abdominal tumor was found. She died and autopsy revealed metastasis of the brain tumor via the ventriculoperitoneal shunt. Intraperitoneal tumors were found in the peritoneum, liver, G-I tract and pancreas. Microscopical diagnosis showed glioblastoma.
Ventriculoperitoneal shunts are very popular and effective procedures to control intracranial pressure. However it should be considered whenever a shunt is performed on a brain tumor, an artificial route for metastasis via the shunt tube is also created. Protection and treatment for metastasis of brain tumors via ventriculoperitoneal shunts should be prepared.