title: Unusual presentation of adult metastatic peritoneal medulloblastoma associated with a ventriculoperitoneal shunt: a case study and review of the literature.
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.
authors.affiliation: Division of Gynecologic Oncology, Department of Obstetrics/Gynecolory, Mayo Graduate School of Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA. magtibay.paul@mayo.edu
authors.forename: Paul M
authors.initials: PM
authors.lastname: Magtibay
authors.forename: Jonathan A
authors.initials: JA
authors.lastname: Friedman
authors.forename: Ravi D
authors.initials: RD
authors.lastname: Rao
authors.forename: Jan C
authors.initials: JC
authors.lastname: Buckner
authors.forename: William A
authors.initials: WA
authors.lastname: Cliby
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D008527:Medulloblastoma / Q000000981:diagnostic imaging* / Q000628:therapy; D010534:Peritoneal Neoplasms / Q000000981:diagnostic imaging* / Q000628:therapy; D011859:Radiography; D017287:Ventriculoperitoneal Shunt / Q000009:adverse effects* / Q000379:methods