Gliomatosis peritonei as a complication of a ventriculoperitoneal shunt: Case report and review of the literature

Gliomatosis peritonei, the implantation of neuroglial tissue upon the perit oneal surfaces, is a rare event most often associated with solid or immatur e teratomas of the ovary in young girls. The authors report a case of a 10- month-old girl with a ventriculoperitoneal shunt (VPS) who presented with b ilateral inguinal hernias. Herniorrhaphy was uneventful. Microscopic examin ation of the hernia sacs showed exuberant mesothelial hyperplasia containin g multiple nests of differentiated glial tissue. Subsequent computed tomogr aphy and laparoscopy disclosed normal ovaries with no evidence of intraabdo minal or pelvic abnormalities. Gliomatosis peritonei in this case was attri buted to transport of glial tissue from the cerebrospinal fluid into the pe ritoneal cavity via the shunt. With the exclusion of an ovarian germ cell n eoplasm and in the presence of a VPS, the clinical course with regard to th e glial implants in these children is uneventful. If it is appreciated that gliomatosis peritonei may be a complication of a VPS, an extensive clinica l evaluation generally is unnecessary. Copyright (C) 2000 by W.B. Saunders Company.