Non-Malignant Cerebrospinal Fluid Ascites in a Patient with Atypical Teratoid Rhabdoid Tumor

Abstract

Background: The development of symptomatic ascites from a ventriculoperitoneal shunt is rare in children without prior intra-abdominal pathology. Here we report a case of symptomatic ascites in a young child with a ventriculoperitoneal shunt and metastatic atypical teratoid rhabdoid tumor. Case Report: This 15-month-old boy developed symptomatic ascites while undergoing chemotherapy for his malignant brain tumor. Diagnostic work up to identify the etiology of this ascites yielded a non-malignant, sterile transudate, refractory to repeated paracentesis. The ascites finally resolved with the conversion of the ventriculoperitoneal shunt to a ventriculoatrial shunt. Conclusion: This case report highlights the need to be suspicious of non-malignant cerebrospinal fluid ascites as a cause of peritoneal fluid accumulation even in children with malignant primary brain tumor. In this setting, conversion of the shunt from peritoneal to atrial drainage can rapidly alleviate the morbidity associated with this condition.