Giant Craniopharyngioma Complicated by Cerebrospinal Fluid Ascites in a 7-Year-Old Boy: A Case Report and Review of Literature

Maryem Tanweer ¹, Syed Haider Hassan ², Momin Bashir ³

⁰Maryem Tanweer, MBBS, Postgraduate Resident Neurosurgery, Department of Neurosurgery Unit-I, Punjab Institute of Neurosciences, Lahore, Pakistan.

Pakistan Journal of Medical Sciences +

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January 12, 2026

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Summary

A rare complication of cerebrospinal fluid (CSF) ascites occurred after ventriculoperitoneal (VP) shunting for a giant craniopharyngioma in a child. Early recognition and management are crucial for this rare but serious condition.

Area Of Science

Pediatric Neurosurgery
Pediatric Oncology
Neuropathology

Background

Craniopharyngioma (CPG) is a rare, benign brain tumor impacting the sellar/parasellar region in children.
Giant CPGs can lead to increased intracranial pressure and hydrocephalus, often necessitating ventriculoperitoneal (VP) shunting.
Complications following VP shunting, though infrequent, require careful consideration in pediatric neurosurgery.

Purpose Of The Study

To highlight a rare but critical complication of CSF ascites post-VP shunting in a pediatric patient with giant craniopharyngioma.
To emphasize the importance of early recognition and timely intervention for managing shunt-related complications.
To inform clinicians about potential management strategies for CSF ascites in this specific patient population.

Main Methods

Case report of a seven-year-old boy with a giant craniopharyngioma.
Details of surgical intervention including tumor excision and VP shunt placement.
Documentation of subsequent complications, shunt revisions, infection, and patient outcome.

Main Results

The patient developed abdominal cerebrospinal fluid (CSF) ascites after VP shunt placement for a giant craniopharyngioma.
Subsequent shunt revisions and a Pseudomonas infection complicated the postoperative course.
The patient ultimately succumbed to acute respiratory distress syndrome and hospital-acquired pneumonia.

Conclusions

Cerebrospinal fluid (CSF) ascites is a rare but significant complication following VP shunting in pediatric patients with giant craniopharyngioma.
Prompt diagnosis and appropriate management, including shunt modification, are essential for improving patient outcomes.
Awareness of this complication and alternative shunting options is critical for clinicians managing these complex cases.

Keywords:

Ascites Craniopharyngioma Neurosurgery Pakistan Ventriculoperitoneal shunt