Kelly Bridges1, Rebecca Sauerwein1, Marjorie R Grafe2, Vassiliki Liana Tsikitis3, Aaron Halfpenny2, Ahmed M Raslan4. 1. Department of Neurological Surgery, Oregon Health & Science University, Portland, Oregon, USA. 2. Department of Pathology (Neuropathology), Oregon Health & Science University, Portland, Oregon, USA. 3. Department of Surgery, Division of Gastrointestinal and General Surgery, Oregon Health & Science University, Portland, Oregon, USA. 4. Department of Neurological Surgery, Oregon Health & Science University, Portland, Oregon, USA. Electronic address: raslana@ohsu.edu].
Abstract
BACKGROUND: Ventriculoperitoneal shunt (VPS) placement has been implicated in extraneural metastasis of many primary central nervous system tumors. Reported cases include, but are not limited to, medulloblastoma, germ cell tumor, astrocytoma, oligodendroglioma, lymphoma, ependymoma, melanoma, and choroid plexus tumors. However, a literature review reveals no reported cases of extraneural metastasis of solitary fibrous tumor/hemangiopericytoma (SFT/HPC). CASE DESCRIPTION: Here we report the case of a 34-year-old man with recurrent intracranial malignant SFT/HPC who had undergone surgical tumor resection and subsequent placement of a VPS for obstructive hydrocephalus in 2004. Subsequently, the patient presented in 2011 and again in 2013 with abdominal SFT/HPC metastasis likely caused by the presence of the VPS. CONCLUSION: The case raises concern regarding placement of a VPS in patients with obstructive hydrocephalus caused by SFT/HPC. To avoid spread of SFT/HPC to the abdomen, we propose that patients with intracranial SFT/HPC and obstructive hydrocephalus be treated primarily by endoscopic third ventriculostomy. Published by Elsevier Inc.
BACKGROUND: Ventriculoperitoneal shunt (VPS) placement has been implicated in extraneural metastasis of many primary central nervous system tumors. Reported cases include, but are not limited to, medulloblastoma, germ cell tumor, astrocytoma, oligodendroglioma, lymphoma, ependymoma, melanoma, and choroid plexus tumors. However, a literature review reveals no reported cases of extraneural metastasis of solitary fibrous tumor/hemangiopericytoma (SFT/HPC). CASE DESCRIPTION: Here we report the case of a 34-year-old man with recurrent intracranial malignant SFT/HPC who had undergone surgical tumor resection and subsequent placement of a VPS for obstructive hydrocephalus in 2004. Subsequently, the patient presented in 2011 and again in 2013 with abdominal SFT/HPC metastasis likely caused by the presence of the VPS. CONCLUSION: The case raises concern regarding placement of a VPS in patients with obstructive hydrocephalus caused by SFT/HPC. To avoid spread of SFT/HPC to the abdomen, we propose that patients with intracranial SFT/HPC and obstructive hydrocephalus be treated primarily by endoscopic third ventriculostomy. Published by Elsevier Inc.
Entities:
Keywords:
Endoscopic third ventriculostomy; Hemangiopericytoma; Obstructive hydrocephalus; Ventriculoperitoneal shunt
Authors: Robert C Nickl; Vera Nickl; Magnus Schindehütte; Camelia-Maria Monoranu; Ralf-Ingo Ernestus; Mario Löhr Journal: J Neurosurg Case Lessons Date: 2022-10-17