Case Report: CSF pseudocyst in the breast

Abstract

A cerebrospinal fluid (CSF) pseudocyst can rarely occur in the breast. It usually results from damage to a ventriculoperitoneal (VP) shunt during a mammogram or augmentation breast surgery. If fluid collection is seen in close proximity to the VP shunt, it should raise the suspicion of a CSF pseudocyst.

Ventriculomammary shunt: An unusual ventriculoperitoneal shunt complication

“…Including our patient, reported breast-related shunt complications comprise of 13.6% (3/ 22) shunt fractures and local leaks with breast pseudocyst [5][6][7][8], 9% (2/22) breast carcinoma invasion, 9% (2/22) breast implant perforation, 13.6% (3/22) retrograde CSF tracking from abdomen [10], and 50% (11/22) distal catheter migration into the breast [5,9]. The median age of diagnosis was 50 years (range: 13 to 88 years), and the mean time from surgery to presentation was 23.3 weeks (range: 1 week to 3 years).…”

Breast-Related CSF Shunt Complications: Literature Review with Illustrative Case

“…Less common in VP shunts are complications related to the thoracic tubing. (2–9) Breast‐related complications represent a class of thoracic VP shunt complications and are characterized by one or more of the following features: breast CSF pseudocyst, shunt migration, CSF “galactorrhoea”, and shunt obstruction (10–24). The Table 1 lists the reported cases of breast‐related shunt complications with associated features.…”

“…Although the first case of breast pseudocyst was described in conjunction with shunt migration (24), all subsequent reported cases of CSF pseudocyst in the normal breast occurred without shunt migration (18,20–22,24). Retrograde flow of CSF around the catheter track provides a mechanism for CSF egress from the peritoneal cavity to the breast tissues (23).…”

A case of breast cancer involving a ventriculoperitoneal shunt

“…Complications frequently associated with a VP shunt, including shunt obstruction, infection, overdrainage of CSF, and perforation of the gastrointestinal tract, gallbladder, vagina, and abdominal wall at the umbilicus, have also been reported [ 1 ]. Regarding complications associated with the mammary gland, CSF pseudocysts due to the leakage of CSF from the catheter shunt obstruction, CSF galactorrhea, and shunt migration of the VP shunting catheter under or within silicone breast implants have been previously reported; however, they are considered to be very rare [ 2 – 5 ].…”