Subject(s)
Cerebral Ventricle Neoplasms/complications , Cerebral Ventricle Neoplasms/pathology , Gait Disorders, Neurologic/etiology , Gait Disorders, Neurologic/pathology , Papilloma, Choroid Plexus/complications , Papilloma, Choroid Plexus/pathology , Adult , Biomarkers, Tumor/analysis , Biopsy , Brain Stem/pathology , Brain Stem/physiopathology , Calcinosis/pathology , Calcinosis/physiopathology , Cerebral Ventricle Neoplasms/physiopathology , Diagnosis, Differential , Fourth Ventricle/pathology , Fourth Ventricle/physiopathology , Gait Disorders, Neurologic/physiopathology , Humans , Male , Neurosurgical Procedures , Papilloma, Choroid Plexus/physiopathology , Tomography, X-Ray Computed , Treatment Outcome , VentriculostomyABSTRACT
BACKGROUND: A case of a 13-month-old male infant with progressive increase in head circumference, neurodevelopmental delay, and episodic generalized seizures is reported. He had a history of increase in intracranial pressure because of an arachnoid cyst at the age of 2 months which was managed by cystoperitoneal shunting, but the symptoms were still progressive. DISCUSSION: Magnetic resonance imaging revealed an intraventricular cystic tumor with intensely enhancing mural nodules. He underwent surgery and the cyst with the nodules was totally excised. Histopathological findings confirmed the diagnosis of cystic choroid plexus papilloma. CONCLUSION: We recommend precise evaluation of intracranial cystic lesions to prevent wrong diagnosis and operation. Total resection of all enhancing nodules in cystic choroid plexus papilloma is proposed to warrant total cure of tumor.
Subject(s)
Arachnoid Cysts/complications , Choroid Plexus Neoplasms , Papilloma, Choroid Plexus , Choroid Plexus Neoplasms/pathology , Choroid Plexus Neoplasms/physiopathology , Humans , Infant , Magnetic Resonance Imaging/methods , Male , Papilloma, Choroid Plexus/pathology , Papilloma, Choroid Plexus/physiopathologyABSTRACT
BACKGROUND: Choroid plexus papillomas are typically considered benign lesions, but histology is not always predictive of their behavior. These tumors can metastasize anywhere along the neuraxis and may be intraventricular, subarachnoid, or intraparenchymal. We present 2 cases that illustrate the wide diversity with which choroid plexus papillomas can disseminate. CASE DESCRIPTIONS: The patient described in case 1 had a primary fourth ventricular choroid plexus papilloma that produced diffuse cystic subarachnoid and leptomeningeal lesions. Patient 2 also had a primary fourth ventricular tumor but with subsequent suprasellar and spinal drop metastases. Patient 1 was treated with temozolomide, resulting in regression of symptoms including headache and dizziness. Patient 2 has been treated with several modalities, including radiation therapy and chemotherapy, with slowing of symptom progression. CONCLUSIONS: Variations of choroid plexus papilloma dissemination include intraventricular, subarachnoid, and leptomeningeal nodules or cystic lesions, and intraparenchymal locations. There is no consensus on the most effective treatment for choroid plexus papilloma metastases; surgical resection, chemotherapy, and radiation therapy may all yield benefits. The prognosis for patients with disseminated choroid plexus papilloma can range from prolonged stable disease and symptoms to death within months.
