Pediatric CSFoma

Etiology: Complication of ventriculoperitoneal shunt
Imaging: Cystic abdominal mass surrounding tip of ventriculoperitoneal shunt
DDX:
Complications: Can cause shunt malfunction, can become infected
Treatment: Drainage with temporary diversion of ventriculoperitoneal shunt
Clinical: May present with elevated intracranial pressure and abdominal pain

Radiology Cases of CSFoma

Radiograph and ultrasound of CSFoma — AP and lateral radiographs of the abdomen show the VP shunt to be coiled upon itself and there is a suggestion of a retrogastric mass on the lateral view. Transverse US of the left upper quadrant of the abdomen shows a large cystic structure with the VP shunt tip within it.

CT of CSFoma — Axial CT with intravenous and oral contrast of the abdomen shows an extremely large mass filling the abdomen with the tip of the VP shunt within it which is causing hydronephrosis and displacement of the bowel.

CT of CSFoma / Cerebrospinal fluid pseudocyst — Axial CT without contrast of the abdomen shows a VP shunt in the anterior right abdomen that is coursing between two low density fluid collections and whose tip is in the fluid collection nearest to the midline.

CT of CSFoma / cerebrospinal fluid pseudocyst — Axial CT with contrast of the abdomen (above) shows the VP shunt anteriorly in the abdomen coursing through a multiloculated fluid collection on the left side of the abdomen. Coronal CT (below left) shows multiple dilated loops of proximal small bowel while the sagittal CT (below right) shows the fluid collection to have at least 3 locules.

Radiology Cases of CSFoma in the Anterior Abdominal Wall

CT of a CSFoma / cerebrospinal fluid pseudocyst in the anterior abdominal wall — Axial (above) and coronal (below) CT with contrast of the abdomen shows a round low density fluid collection in the subcutaneous tissues of the right anterior abdominal wall with inflammatory changes noted around the fluid collection. In the center of the fluid collection is a coiled ventriculoperitoneal shunt.