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CC BY-NC-ND 4.0 · Arquivos Brasileiros de Neurocirurgia: Brazilian Neurosurgery 2024; 43(03): e222-e225
DOI: 10.1055/s-0043-1777754
Case Report

Ventriculovesical Shunting in a Patient with Leptomeningeal Carcinomatosis: An Alternative to VP Shunts. A Technique Report

Derivação ventriculovesical em paciente com Carcinomatose Leptomeníngea: Uma alternativa às DVPs. Relato de técnica
Luiz Henrique Vargas de Andrade 
1   Medicine Department, Faculty of Medicine, Universidade Estadual de Ponta Grossa, Ponta Grossa, PR, Brazil
,
João Pedro Motter de Carvalho
1   Medicine Department, Faculty of Medicine, Universidade Estadual de Ponta Grossa, Ponta Grossa, PR, Brazil
,
Arthur Garani Narciso
1   Medicine Department, Faculty of Medicine, Universidade Estadual de Ponta Grossa, Ponta Grossa, PR, Brazil
,
Alexandre Rossato Félix
2   Neurological Surgery Department, Hospital Geral Unimed, Ponta Grossa, PR, Brazil
,
Alisson Fucio
3   Urologic Surgery Department, Hospital Geral Unimed, Ponta Grossa, PR, Brazil
,
Leonardo Christiaan Welling
4   Neurological Surgery Department, Faculty of Medicine, Universidade Estadual de Ponta Grossa, Ponta Grossa, PR, Brazil
,
Nicolas N. Rabelo
5   Department of Neurology, Neurosurgery Service, Faculty of Medicine, Hospital das Clínicas, Universidade de São Paulo, São Paulo, SP, Brazil
,
Eberval Gadelha Figueiredo
5   Department of Neurology, Neurosurgery Service, Faculty of Medicine, Hospital das Clínicas, Universidade de São Paulo, São Paulo, SP, Brazil
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Abstract

Leptomeningeal carcinomatosis (LC) is a rare but serious complication when cancer cells infiltrate the meninges. It is most commonly associated with breast cancer, but only 5% of breast cancer patients develop it. Leptomeningeal carcinomatosis typically presents with headaches, mainly due to hydrocephalus, and the diagnosis involves a cytological analysis of cerebrospinal fluid (CSF) and/or magnetic resonance imaging (MRI) scans. The treatment of LC consists of a combination of intra-CSF chemotherapy, systemic therapy, radiation therapy, and/or supportive care, including CSF drainage. In the case herein reported, a technique known as ventriculovesical shunting was performed on a female patient with LC and breast cancer who had hydrocephalus due to this condition. This procedure is not as common as ventriculoperitoneal shunts, which can lead, in this case, to serious complications such as peritoneal carcinomatosis.

Resumo

Carcinomatose leptomeníngea (CL) é uma complicação infrequente, porém séria, que ocorre quando células cancerígenas infiltram as meninges. É mais comumente associada ao câncer de mama, mas apenas 5% dos pacientes com câncer de mama a desenvolvem. A CL apresenta-se tipicamente com dores de cabeça decorrentes principalmente da hidrocefalia, e o diagnóstico envolve uma análise citológica do líquido cefalorraquidiano (LCR) e/ou ressonância magnética (RM). O tratamento da CL envolve uma combinação de quimioterapia intra-LCR, terapia sistêmica, radioterapia e/ou cuidados de suporte, incluindo a drenagem do LCR. No caso aqui relatado, realizou-se uma técnica conhecida como derivação ventriculovesical em uma paciente feminina com CL e câncer de mama que tinha hidrocefalia em decorrência desta situação. Este procedimento não é tão comum em comparação com as derivações ventriculoperitoneais, as quais, nesse caso, podem levar à carcinomatose peritoneal.

Keywords

meningeal carcinomatosis - neoplasm metastasis - hydrocephalus - cerebrospinal fluid shunts - neurosurgery

Palavras-chave

carcinomatose meníngea - metástase neoplásica - hidrocefalia - derivações do líquido cefalorraquidiano - neurocirurgia


Publication History

Received: 08 March 2023

Accepted: 13 September 2023

Article published online:
02 May 2024

© 2024. Sociedade Brasileira de Neurocirurgia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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