Intracranial germ cell tumor metastasis to the peritoneal cavity through the ventriculoperitoneal shunt

Abstract

Intracranial germ cell tumors (GCTs) are uncommon and may cause obstructive hydrocephalus, making adequate drainage necessary in symptomatic patients. Here, we present the case of a 36-year-old male patient with intracranial germinoma metastasis to the peritoneal cavity. He had a medical history of pineal germinoma status post ventriculoperitoneal (VP) shunt implantation and definitive radiotherapy. Two years later, the patient presented with epigastric pain, and intra-abdominal metastasis through the VP shunt with malignant transformation to a nongerminomatous GCT was noted. Chemotherapy followed by surgical resection was arranged, and he got disease free after treatment. The present report alerts clinicians to the progression of this uncommon disease and suggests that a thorough physical examination is imperative in patients with a history of intracranial GCTs who have undergone VP shunt implantation, and an alternative therapeutic plan should be considered to treat intracranial GCT-related obstructive hydrocephalus.

Keywords

• intracranial germ cell tumor
• germinoma
• ventriculoperitoneal shunt
• metastases
• malignancy transformation