A case report of abdominal implantation and metastasis caused by transventricular peritoneal drainage tube after radiotherapy for intracranial pituitary tumor

IF 0.4 Q4 CLINICAL NEUROLOGY

Interdisciplinary Neurosurgery: Advanced Techniques and Case Management Pub Date : 2025-02-07 DOI:10.1016/j.inat.2025.101996

Chao Ma, Yuxin Fan, Tianyong Cai, Zheyong Li

{"title":"A case report of abdominal implantation and metastasis caused by transventricular peritoneal drainage tube after radiotherapy for intracranial pituitary tumor","authors":"Chao Ma, Yuxin Fan, Tianyong Cai, Zheyong Li","doi":"10.1016/j.inat.2025.101996","DOIUrl":null,"url":null,"abstract":"<div><h3>Introduction and importance</h3><div>This article reports the diagnosis and treatment of a patient with a malignant pituitary tumor who underwent transtumoral ventriculo-abdominal drainage and multiple radiotherapies.</div></div><div><h3>Case presentation</h3><div>The patient exhibited intraperitoneal metastasis and was admitted due to abnormal menopause. Diagnostic examination revealed pituitary gland space occupation, leading to cranial brain surgery. Cerebrospinal fluid was sampled during the operation for cytological examination to consider germinoma. However, the complete removal of the pituitary tumor was hindered by severe cerebral edema, necessitating the temporary placement of a ventriculo-abdominal drainage tube. Following the operation, the patient received 23 sessions of directed radiotherapy, resulting in tumor disappearance as confirmed by pituitary MRI review. Three years later, the patient returned to the hospital due to abdominal pain and anorexia, revealing a substantial abdominal cavity mass. Active surgical intervention was conducted, and postoperative pathology confirmed a secondary malignant tumor in the abdominal cavity originating from dysgerminoma. Following treatment, the patient’s condition improved, and they were discharged. However, intra-abdominal tumor recurrence ensued due to delayed chemotherapy administration, ultimately resulting in death from extensive cerebral infarction.</div></div><div><h3>Clinical discussion</h3><div>When encountering such patients in the future, if surgery is necessary, how can we select patients who require postoperative maintenance treatment? Which regimen offers greater benefits compared to radiotherapy or chemotherapy? In cases where patients are unable to tolerate chemotherapy and radiotherapy, how can we provide a more specialized treatment plan for them?</div></div><div><h3>Conclusion</h3><div>Analysis of this report underscores the potential enhancement of clinical treatment strategies for such cases.</div></div>","PeriodicalId":38138,"journal":{"name":"Interdisciplinary Neurosurgery: Advanced Techniques and Case Management","volume":"39 ","pages":"Article 101996"},"PeriodicalIF":0.4000,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Interdisciplinary Neurosurgery: Advanced Techniques and Case Management","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2214751925000088","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Introduction and importance

This article reports the diagnosis and treatment of a patient with a malignant pituitary tumor who underwent transtumoral ventriculo-abdominal drainage and multiple radiotherapies.

Case presentation

The patient exhibited intraperitoneal metastasis and was admitted due to abnormal menopause. Diagnostic examination revealed pituitary gland space occupation, leading to cranial brain surgery. Cerebrospinal fluid was sampled during the operation for cytological examination to consider germinoma. However, the complete removal of the pituitary tumor was hindered by severe cerebral edema, necessitating the temporary placement of a ventriculo-abdominal drainage tube. Following the operation, the patient received 23 sessions of directed radiotherapy, resulting in tumor disappearance as confirmed by pituitary MRI review. Three years later, the patient returned to the hospital due to abdominal pain and anorexia, revealing a substantial abdominal cavity mass. Active surgical intervention was conducted, and postoperative pathology confirmed a secondary malignant tumor in the abdominal cavity originating from dysgerminoma. Following treatment, the patient’s condition improved, and they were discharged. However, intra-abdominal tumor recurrence ensued due to delayed chemotherapy administration, ultimately resulting in death from extensive cerebral infarction.

Clinical discussion

When encountering such patients in the future, if surgery is necessary, how can we select patients who require postoperative maintenance treatment? Which regimen offers greater benefits compared to radiotherapy or chemotherapy? In cases where patients are unable to tolerate chemotherapy and radiotherapy, how can we provide a more specialized treatment plan for them?

Conclusion

Analysis of this report underscores the potential enhancement of clinical treatment strategies for such cases.

查看原文本刊更多论文

颅内垂体瘤放疗后经脑室腹膜引流管引起腹腔植入转移1例

本文报告1例经口脑室腹腔引流及多重放射治疗的恶性垂体瘤的诊断和治疗。病例表现：患者出现腹腔内转移，因绝经异常入院。诊断检查发现垂体间隙占位，导致颅脑手术。术中抽取脑脊液作细胞学检查，考虑是否有生殖细胞瘤。然而，严重的脑水肿阻碍了垂体肿瘤的完全切除，需要暂时放置脑室-腹腔引流管。术后患者接受定向放疗23次，经垂体MRI复查证实肿瘤消失。三年后，患者因腹痛和厌食返回医院，发现腹腔内有大量肿块。积极进行手术干预，术后病理证实腹腔继发性恶性肿瘤起源于生殖细胞异常瘤。经治疗，患者病情好转，出院。然而，由于化疗延迟，腹腔内肿瘤复发，最终导致大面积脑梗死死亡。临床讨论今后遇到这样的患者，如果需要手术，如何选择需要术后维持治疗的患者？与放疗或化疗相比，哪一种治疗方案更有益处？如果患者无法耐受化疗和放疗，我们如何为他们提供更专业的治疗方案？结论本报告的分析强调了对此类病例的临床治疗策略的潜力。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊