EXTRACRANIAL METASTASIS OF MEDULLOBLASTOMA IN THE ADULT VIA CEREBROSPINAL-FLUID SHUNT - DESCRIPTION OF A CASE AND LITERATURE-REVIEW

About 25-30% of medulloblastomas, a typical childhood tumor, appear in adults patients. In these last patients medulloblastoma shows certain features that make it different from medulloblastoma in children, such as its more lateral location (usually cerebellar hemispheres), histology (of the desmoplastic type) and an easier total or subtotal removal. However, it is not clear whether these pecularities influence the final prognosis. Medulloblastoma is the CNS tumor that more often metastatizes outside the CNS, mainly involving skeleton (77 %), lymph nodes (33%) and lung (17%). However, metastases in adulthood, and especially the extraneural ones, are uncommon. CSF shunting increases the frequency and accelerates the appearance of systemic metastases and notably makes this patients prognosis worse. The authors present the case of a woman with a diagnosis of cerebellar medulloblastoma who had a ventriculoperitoneal shunt inserted previous to conventional surgery, who three years later developed peritoneal metastases unequivocally related to previous shunt.