Follow-up study on metastatic cerebellar tumor surgery--characteristic problems of surgical treatment

Recently, the incidence of metastatic cerebellar tumors has increased. The authors operated on 12 cases of metastatic cerebellar tumors, with total or subtotal removal of nodules in brain metastases. Surgical complications observed as a result of postoperative investigation are presented. 1) Some cases developed carcinomatous meningitis within a short period. During removal of a tumor on the superior cerebellar surface attention should be paid to the prevention of dissemination to the cerebral cisterns adjacent to the tumor. 2) Some cases demonstrated peritoneal metastasis probably due to dissemination via the ventriculoperitoneal shunt tube, suggesting that great care should be taken during a shunt operation after removal. 3) Both carcinomatous meningitis occurring after removal and remote metastasis via the shunt tube were related to recurrence after removal of the cerebellar metastatic lesion, raising the issue of whether or not total macroscopic removal should be included in the indications for surgical treatment of cerebellar metastasis. Those cases in which surgery is indicated should also be routinely treated by postoperative irradiation.