Case ReportProgression of choroid plexus papilloma
Introduction
Choroid plexus tumours are rare, comprising 0.3–0.6% of all intracranial tumours. Histologically, 80% are choroid plexus papillomas (CPP), 15% are atypical papillomas, and less than 5% are carcinomas.1 Progression from a benign CPP to a higher grade atypical CPP or choroid plexus carcinoma (CPC) is rare.2 We report two patients with interval histological progression.
Section snippets
Patient 1
A 53-year-old woman presented in 2005 with a history of headaches. Imaging showed a left lateral ventricular lesion (Fig. 1a, b). She underwent total resection via an interhemispheric transcallosal approach. Histopathology and immunohistochemistry were consistent with World Health Organization (WHO) grade I CPP (Fig. 2a). Yearly imaging between 2005 and 2009 showed no recurrence. In 2009, she re-presented with recurrent headaches. Imaging showed four new intraventricular lesions (Fig. 1c, d).
Discussion
CPPs are most common in childhood, accounting for around 4% of paediatric intracranial tumours.3 Fifty per cent are found in the lateral ventricles, 40% in the fourth ventricle and 5% in the third ventricle. Around 5% of patients have synchronous lesions at diagnosis. Clinically, CPP usually present with headaches secondary to hydrocephalus which is due to overproduction of CSF by the tumour, but can also be due to obstruction of CSF flow.1 CPP is best managed with gross total resection via a
Conclusions
CPP are benign tumours. However, there are reports of late recurrences, metastasis and histological progression. Hence, these patients need prolonged follow-up. Progression to atypical CPP and CPC can occur rarely, and warrants consideration of adjuvant treatment.
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Cited by (13)
Choroid Plexus Papillomas of the Cerebellopontine Angle
2016, World NeurosurgeryCitation Excerpt :All the patients in the present study underwent long-term clinical follow-up and serial imaging. Benign CPPs infrequently progress to a higher grade APP or CPC.50 Jeibmann et al.51 reported that only 2 of 124 patients experienced a transition from a CPP and an APP to CPCs.
Disseminated choroid plexus papillomas in adults: A case series and review of the literature
2016, Journal of Clinical NeuroscienceCitation Excerpt :Choroid plexus papilloma (CPP) is a rare primary neuroectodermal tumor of the choroid plexus, accounting for less than 1% of all intracranial neoplasms and 2–4% of brain tumors in children [1]. Histologically, 80% of choroid plexus tumors are papillomas, 15% are atypical papillomas (ACPP), and less than 5% are carcinomas (CPC) [2]. These tumors, in adults, commonly present in the fourth ventricle, arising from the caudal roof with signs and symptoms of hydrocephalus, such as headache, diplopia and ataxia.
Atypical choroid plexus papilloma in suprasellar region of elderly with impaired vision as main symptom:A case report and literature review
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