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Updated: Jul 5, 2026
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Published on: July 5, 2021
Radiation-induced meningioma concealed by shunt valve artifact: case report
Richard H Singleton1, Harry Kellermier, L Dade Lunsford
1Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania 15213, USA. singletonrh@upmc.edu
Objective:
Ventricular shunting is a common neurosurgical procedure. Metal-containing shunt components can cause artifacts on magnetic resonance imaging (MRI), obscuring visualization of the surrounding tissue. We present the case of a radiation-induced meningioma growing around a ventricular catheter that was not noted at an early stage as a result of artifact from an overlying shunt.
Clinical Presentation:
We present the case of a 27-year-old survivor of a childhood medulloblastoma who required ventriculoperitoneal shunting as a consequence of her treatment. As a result of radiation-induced meningiomas that developed in adolescence, the patient was screened biennially via contrasted MRI. Her most recent imaging revealed a new meningioma at the edge of the MRI artifact associated with the shunt valve. A contrasted computed tomographic scan demonstrated a large meningioma with mass effect on the surrounding brain.
Intervention:
Complete surgical resection of the meningioma was obtained. The ventricular catheter was preserved and the shunt valve replaced with a newer system that is reported to generate less magnetic artifact.
Conclusion:
Artifact from shunt valves or other implanted metallic devices obscures the surrounding tissues on MRI. Patients with significant artifact who are at higher risk for development of intracranial pathology may benefit from periodic imaging through alternate modalities that are not susceptible to magnetic artifact.
Insights
Magnetic resonance imaging (MRI) artifacts from ventricular shunts can obscure tumors. Alternate imaging modalities are recommended for patients with high-risk intracranial pathology and significant shunt artifact.
Area of Science:
- Neurosurgery
- Radiology
- Oncology
Background:
- Ventricular shunting is a common neurosurgical procedure to manage cerebrospinal fluid imbalances.
- Metal components in shunts can create artifacts on MRI, hindering visualization of adjacent brain structures.
- Radiation-induced meningiomas are a known complication in patients treated for medulloblastoma.
Observation:
- A 27-year-old patient with a history of medulloblastoma developed radiation-induced meningiomas.
- MRI screening revealed a new meningioma obscured by artifact from a ventriculoperitoneal shunt valve.
- CT scan confirmed a large meningioma with significant mass effect.
Findings:
- Surgical resection of the meningioma was successful.
- The shunt valve was replaced with a newer model designed to minimize MRI artifact.
- Early detection of the meningioma was delayed due to shunt-related MRI interference.
Implications:
- MRI artifacts from implanted metallic devices can mask critical pathologies.
- Patients with high-risk intracranial pathology and significant MRI artifact may benefit from alternative imaging techniques.
- Periodic surveillance using non-artifact-generating modalities is crucial for early diagnosis and management.
