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Vol. 6. Issue 1.
Pages 65-71 (January 1995)
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Vol. 6. Issue 1.
Pages 65-71 (January 1995)
Metástasis extracraneales del meduloblatoma en el adulto; diseminación vía derivación L.C.R. Presentación de un caso y revisión de la literatura
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L.J. Martínez Soto, E. Urculo Bareño
Hospital de Guipúzcoa. San Sebastián. Bilbao
E. Areitio Cebrecos*, J. de la Herrán Matorras*
* Hospital de Basurto. Bilbao
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Resumen

El meduloblastoma, tumor típico de la infancia, aparece en un 25–30% de los casos en pacientes adultos. En estos pacientes suele presentar ciertos rasgos que lo diferencian del meduloblastoma en el niño, como son su localización más lateral (hemisferio cerebeloso), ser más frecuente la variante desmoplásica y ser más fácilmente extirpable, aunque no está claro que estas peculiaridades influyan en el pronóstico. El meduloblastoma es el tumor del SNC que más frecuentemente metastatiza fuera del neuroeje afectando sobre todo a huesos (77%), glanglios linfáticos (33%) y pulmón (17%). Sin embargo, las metástasis extraneurales en el adulto son excepcionales. La colocación de una derivación de LCR aumenta la frecuencia y acelera la aparición de metástasis sistémicas y empeora el pronóstico.

Los autores presentan el caso de una mujer con diagnóstico de meduloblatoma cerebeloso a quien se le instauró un shunt ventrículo-peritoneal previo a la cirugía, que presentó tres años después únicamente metástasis peritoneales, en evidente relación con el shunt previo.

Palabras clave:
Meduloblastoma
Adulto
Metástasis extracraneales
Derivación ventrículo-peritoneal
Pronóstico
Summary

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 laterallocation (usually cerebellar hemispheres), histology (of the desmoplasic type) and an easier total or subtotal removal. However, it is not clear whether these peculiarities 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 frecuency and acceleratesthe 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.

Key words:
Medulloblastoma
Adult
Extracraneal metastasis
Ventriculo-peritoneal shunt
Prognosis

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