A case of breast cancer involving a ventriculoperitoneal shunt

Abstract

An 84-year-old woman was examined for an enlargement of an induration in the left breast. A ventriculoperitoneal shunt had been placed for postoperative normal pressure hydrocephalus of a cerebral hemorrhage, and it had penetrated the mass according to the computed tomography findings. Breast cancer was diagnosed after a close examination; however, close observation was selected because her family rejected treatment. She developed somnolence 7 months after the initial examination, and ventricular dilatation and expansion of the low-density region around the ventricle were noted on computed tomography, suggesting that the enlarged tumor had excluded the shunt and caused obstruction. The growth of breast carcinoma involving a shunt tube can be the cause of obstruction of a ventriculoperitoneal shunt. Our findings suggest that a breast lesion should be evaluated at both pre- and postoperation.

Treatment Strategies of Complications of Breast Implants Associated With Ventriculoperitoneal Shunts

“…Literature review returned 34 articles, one of which described two separate patients, bringing cases to a total of 35 breast-related VPS complications (Table 1). 4–37 Seventeen included migration and coiling of the distal catheter inside the breast. Of these 17 patients, 13 had breast implants at the time of migration.…”

“…Breast pseudocysts in patients without breast implants can be managed by the neurosurgery team with shunt revision, with or without percutaneous drainage. Patients with breast cancer-related VPS complications 30,32,34,36 (Table 1) should be managed according to cancer treatment guidelines by a breast surgeon and oncology team, with reconstruction by plastic surgery. For these reasons, we did not include these clinical situations in the algorithm.…”

Appendicitis Causing Ascending Infection Through Ventriculoperitoneal Shunt

“…VPS systems have a lower incidence of complications. In Japan, the use of CSF shunting has been increasing; currently, 16,000 cerebrospinal shunting operations are performed each year [1]. But a number of complications, such as proximal, valvular, and distal obstruction and infection, have been associated with the use of VPS [5].…”

“…VPS are one of the best treatment modalities for neurologic disorders such as hydrocephalus. VPS are widely used; each year approximately 16,000 patients required VPS implantation in Japan [1]. However, the cumulative complication rate of VPS at 5 years is estimated at 32% [2].…”

Cutaneous presentation of gastrointestinal adenocarcinoma

“…Carcinoma surrounding a VP shunt poses a risk of obstruction secondary to tumour enlargement. Obstruction of a VP shunt has been reported in a patient with breast cancer that metastasized to and surrounded the shunt [ 4 ]. Ongoing monitoring for ventricular enlargement may be required, with neurosurgical input to determine if the shunt requires resiting or replacement in the future.…”