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SHUNT-ASSOCIATED INTRA-ABDOMINAL METASTASING OF ATYPICAL TERATOID-RHABDOID BRAIN TUMOR


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Abstract

A clinical case of intra-abdominal metastases of atypical teratoid-rhabdoid brain tumor because of ventriculoperitoneal shunt in a 1 y.o. child is presented. The child was hospitalized with a clinical picture of hypertension-hydrocephalic syndrome, right-sided hemiparesis. By neuroimaging findings, there was a massive tumor of the left lateral ventricle invading into the third, fourth, right lateral ventricles, Silvius aqueduct, metastases in the brain. An open biopsy of the tumor and external ventricular drainage were made. An atypical teratoid-rhabdoid brain tumor was verified histologically. Later, a ventriculoperitoneal shunt (VPS) was implanted. Chemotherapy was performed by ATRO-2006 protocol, though there was a simultaneous marked growth of the residual tumor. Nonprogressive survival period was 8 months. In 10 months after the initial diagnosis, during proton radiation with parallel Vincristine, intra-abdominal metastases were revealed. One month later, the child died. The authors have made a literature review on VPS-associated intra-abdominal metastases of malignant CNS neoplasms, the pathology which leads to an extremely unfavorable prognosis of the disease.


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