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  • Seeding of Abdomen with Primary Intracranial Hemangiopericytoma by a Ventriculoperitoneal Shunt: Case Report

    Final Number:

    Kelly Bridges MD; Hai Sun MD PhD; Ahmed M. Raslan MBBS, MCh; Sauerwein Rebecca

    Study Design:

    Subject Category:

    Meeting: Congress of Neurological Surgeons 2015 Annual Meeting

    Introduction: It has been reported that neurosurgical procedures including ventriculoperitoneal shunt (VPS) placement are implicated in extraneural metastasis of primary intracranial tumors. Reported cases include, but are not limited to, medulloblastoma, germ cell tumor, astrocytoma, oligodendroglioma, lymphoma, ependymoma, melanoma, and choroid plexus tumors. However, from the author’s review of the literature, there has been no reported case of extraneural metastasis of hemangiopericytoma (HPC), until now.

    Methods: The authors report a case of an intracranial malignant hemangiopericytoma where the presence of a VPS may have been the culprit for two subsequent abdominal metastases.

    Results: A 46-year-old gentleman with recurrent intracranial HPC underwent surgical tumor resection and subsequent placement of a VPS for obstructive hydrocephalus in 2004. He presented in 2011 and again in 2013 with abdominal HPC metastasis likely caused by the presence of his VPS.

    Conclusions: This case raises concern regarding placement of a VPS in patients with obstructive hydrocephalus caused by HPC. To avoid spread of HPC to the abdomen, we propose that patients with intracranial HPC and obstructive hydrocephalus be treated primarily by endoscopic third ventriculostomy.

    Patient Care: If endoscopic third ventriculostomy serves as a successful treatment option for tumor-related hydrocephalus, then this can decrease incidence of extraneural metastases, and hopefully prolong life.

    Learning Objectives: By the conclusion of this session, participants should be able to 1) Describe the importance endoscopic third ventriculostomy and tumor-related hydrocephalus, 2) Discuss in small groups alternative options for preventing extraneural metastases, 3) Identify risk factors for extraneural metastases

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