PMC9479584_01
(a) Colonoscopy photograph showing a circumferential lesion in the sigmoid colon that induced stenosis and prevented the scope from passing through. (b) Abdominal computed tomography revealing the sigmoid colon's thickened wall (yellow arrow) and the ventriculoperitoneal (VP) shunt's tip surrounded by the lesion (yellow arrowhead). (c) Laparoscopic photograph showing the VP shunt trapped in the tumor's serosal side. (d) Resected tissue demonstrating the tip of the VP shunt that was removed along with the tumor. No catheter was found in the colonic lumen.
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F1
Colonoscopy showed a sigmoid mass [Figure 1a], the biopsy of which revealed tubular adenocarcinoma. Computed tomography demonstrated circumferential wall thickening of the sigmoid colon without evidence of metastasis, with the lesion surrounding the tip of the VP shunt [Figure 1b]. We opted for laparoscopic surgery, which unexpectedly revealed that the VP shunt was trapped in the tumor's serosal side [Figure 1c]; both the shunt and the tumor were, thus, excised [Figure 1d].
(a) Macroscopic photograph showing the ventriculoperitoneal (VP) shunt (red arrowhead) embedded in a deeper layer than the tumor (red arrow). (b) Microscopic image revealing the VP shunt's tip, covered in vitrification, located on the tumor's serosal side. Fibrosis can be seen outside of the vitrification zone, but no cancer cells are observed (hematoxylin and eosin stain, original magnification x20).
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F2
Macroscopic pathology showed that the VP shunt was stuck in a deeper layer in comparison to the tumor [Figure 2a], while microscopic examination of the tumor revealed subserosal invasion. Inflammation and fibrosis were also identified, but no cancer cells were found in the serosa surrounding the embedded VP shunt tip [Figure 2b].