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Andour H, Ben El Hend S, Mandour C, Allaoui M, Fikri A. Atypical choroid plexus papilloma: Diagnosis and differentials: A case report. SAGE Open Med Case Rep 2024; 12:2050313X241254000. [PMID: 38764919 PMCID: PMC11102693 DOI: 10.1177/2050313x241254000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Accepted: 04/24/2024] [Indexed: 05/21/2024] Open
Abstract
Atypical choroid plexus papilloma is a rare World Health Organization grade 2 intraventricular tumor arising from the epithelium of the plexus choroid with intermediate clinical-pathological features between the benign choroid plexus papilloma and the malignant choroid plexus carcinoma. The main criteria for differentiation are histopathologic, with difficulties in distinguishing it from choroid plexus papilloma based on imaging features. We report the case of a 4-year-old female presenting with headaches and altered mental status. Brain magnetic resonance imaging revealed a right lateral ventricular mass with some atypical characteristics, which were confirmed on pathological examination as an atypical choroid plexus papilloma.
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Affiliation(s)
- H. Andour
- Radiology Department, Military Hospital Mohammed V-Rabat, Rabat, Morocco
| | - S. Ben El Hend
- Radiology Department, Military Hospital Avicennes, Marrakech, Morocco
| | - C. Mandour
- Neurosurgery Department, Military Hospital Mohammed V-Rabat, Rabat, Morocco
| | - M. Allaoui
- Anatomopathology Department, Military Hospital Mohammed V-Rabat, Rabat, Morocco
| | - A. Fikri
- Radiology Department, Military Hospital Avicennes, Marrakech, Morocco
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Adib SD, Hempel JM, Kandilaris K, Grimm F, Zamora RE, Tatagiba M. Surgical management of choroid plexus papilloma of the cerebellopontine and cerebellomedullary angle: classification and strategy. Neurosurg Rev 2021; 44:3387-3397. [PMID: 33629235 PMCID: PMC8592964 DOI: 10.1007/s10143-021-01506-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2020] [Revised: 01/15/2021] [Accepted: 02/14/2021] [Indexed: 11/24/2022]
Abstract
Choroid plexus papillomas (CPPs) are primary neuroectodermal neoplasms that usually arise in the fourth ventricle in adults. In this study, we present 12 patients with CPP arising from the cerebellopontine angle (CPP-CPA) and/or of the cerebellomedullary angle (CPP-CMA) that were treated in our department. Patients who underwent surgery for the treatment for CPP-CPA/CMA from January 2004 to March 2020 were identified by a computer search of their files from the Department of Neurosurgery, Tübingen. CPPs were classified according to their location into type 1 (tumor portion only in the CPA,), type 2 (tumor portions only in the CMA), and type 3 (tumor portions both in the CPA and CMA). Patients were evaluated for initial symptoms, previous therapies in other hospitals, extent of tumor resection, recurrence rate, and complications by reviewing patient documents. Of approximately 1500 CPA lesions, which were surgically treated in our department in the last 16 years, 12 patients (mean age 42 ± 19 years) were found to have CPP-CPA/CMA. Five were male, and seven were female patients. Gross total resection was achieved in nine cases, and a subtotal resection was attained in three cases. Tumor recurrence in the same location after the first surgery in our hospital was observed in 2 patients after 15 and 40 months of follow-up, and in another patient, distant metastases (C3/4 and L3 levels) were observed. Surgical removal of CPP is the treatment of choice, but additional therapeutic options may be necessary in case of remnant tumor portions, recurrence, or malignant transformation.
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Affiliation(s)
- S D Adib
- Department of Neurosurgery, University of Tuebingen, Hoppe-Seyler-Str. 3, 72076, Tuebingen, Germany.
| | - J M Hempel
- Department of Neuroradiology, University of Tuebingen, Hoppe-Seyler-Str. 3, 72076, Tuebingen, Germany
| | - K Kandilaris
- Department of Neuropathology, University of Tuebingen, Hoppe-Seyler-Str. 3, 72076, Tuebingen, Germany
| | - F Grimm
- Department of Neurosurgery, University of Tuebingen, Hoppe-Seyler-Str. 3, 72076, Tuebingen, Germany
| | - R Evangelista Zamora
- Department of Neurosurgery, University of Tuebingen, Hoppe-Seyler-Str. 3, 72076, Tuebingen, Germany
| | - M Tatagiba
- Department of Neurosurgery, University of Tuebingen, Hoppe-Seyler-Str. 3, 72076, Tuebingen, Germany
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Das B, Girigoswami A, Pal P, Dhara S. Manganese oxide-carbon quantum dots nano-composites for fluorescence/magnetic resonance (T1) dual mode bioimaging, long term cell tracking, and ROS scavenging. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2019; 102:427-436. [PMID: 31147013 DOI: 10.1016/j.msec.2019.04.077] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/04/2018] [Revised: 04/22/2019] [Accepted: 04/23/2019] [Indexed: 01/12/2023]
Abstract
Multimodal long-term imaging probes with capability of extracting complementary information are highly important in biomedical engineering for disease diagnosis and monitoring of therapeutics distribution. However, most of the theranostics probes used are transient and have inherent problem of toxicity mostly related to generation of free radicals. In current study, a simple microwave assisted synthesis of multimodal imaging nanoprobe (T1 contrast in MR/fluorescence) is reported via doping carbon quantum dots into manganese oxide nanoparticles. The nanostructures were characterized by US-Vis spectroscopy, fluorescence spectroscopy, FTIR, Raman spectroscopy, TEM, XRD, AFM and XPS. The average particle size was observed to be around 20-40 nm with a height of 7-9 nm and approximate quantum yield of 0.23. The nanostructures were useful for bio imaging and cell tracking via fluorescence microscopy up to 12 generations with nominal cytotoxicity. The material was capable of scavenging free radicals from cellular microenvironment and downregulate gene expression of free radical scavenging enzymes. The material has significant relaxivity (r1) value of 3.98 mM-1.sec-1 at 1.5 T. It was also observed to create significant contrast with high circulation time (30 min) and renal clearance property. The histological analysis of kidney and liver sections were observed to have no significant toxicity from the nanostructure.
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Affiliation(s)
- Bodhisatwa Das
- School of Medical Science and Technology, Indian Institute of Technology Kharagpur, WB, India
| | - Agnishwar Girigoswami
- Faculty of Allied Health Sciences, Chettinad Hospital & Research Institute (CHRI), Chettinad Academy of Research & Education (CARE), Kelambakkam, Chennai, Tamil Nadu, India
| | - Pallabi Pal
- School of Medical Science and Technology, Indian Institute of Technology Kharagpur, WB, India
| | - Santanu Dhara
- School of Medical Science and Technology, Indian Institute of Technology Kharagpur, WB, India.
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Ito H, Nakahara Y, Kawashima M, Masuoka J, Abe T, Matsushima T. Typical Symptoms of Normal-Pressure Hydrocephalus Caused by Choroid Plexus Papilloma in the Cerebellopontine Angle. World Neurosurg 2016; 98:875.e13-875.e17. [PMID: 27913261 DOI: 10.1016/j.wneu.2016.11.106] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2016] [Revised: 11/18/2016] [Accepted: 11/19/2016] [Indexed: 11/18/2022]
Abstract
BACKGROUND Choroid plexus papillomas (CPPs) are rare benign intracranial tumors. We report a rare case of CPP manifesting with typical symptoms of normal-pressure hydrocephalus rather than obstructive hydrocephalus. CASE DESCRIPTION A 45-year-old woman presented with a 6-year history of headache and typical symptoms of normal-pressure hydrocephalus, including gait disturbance, urinary incontinence, and cognitive dysfunction, in addition to the more common symptoms of CPP, such as lower cranial nerve dysfunctions and ataxia. The CPP arose from the right lateral recess of the fourth ventricle and extended to the cerebellopontine angle. Magnetic resonance imaging did not show any radiographic evidence of obstruction of aqueduct, foramen of Magendie, or foramen of Luschka on the contralateral side. We speculated that hydrocephalus was associated with cerebrospinal fluid overproduction by the CPP originating from the choroid plexus of the lateral recess and extending laterally into the cerebellomedullary fissure (CMF). Surgical excision was performed with a trans-CMF approach. The symptoms of normal-pressure hydrocephalus disappeared. In addition to improved clinical symptoms, radiographic findings showed mitigation of ventricular dilatation. CONCLUSIONS The hydrocephalus was of a communicating type and caused by CSF overproduction. The lateral route of the trans-CMF approach is useful for the dissection of tumors that extend into the unilateral cerebellomedullary cistern through the CMF. This approach not only enables sufficient exposure for resection but also avoids damage to the surrounding structures.
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Affiliation(s)
- Hiroshi Ito
- Department of Neurosurgery, Faculty of Medicine, Saga University, Saga, Japan
| | - Yukiko Nakahara
- Department of Neurosurgery, Faculty of Medicine, Saga University, Saga, Japan.
| | - Masatou Kawashima
- Department of Neurosurgery, Faculty of Medicine, Saga University, Saga, Japan
| | - Jun Masuoka
- Department of Neurosurgery, Faculty of Medicine, Saga University, Saga, Japan
| | - Tatsuya Abe
- Department of Neurosurgery, Faculty of Medicine, Saga University, Saga, Japan
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Luo W, Liu H, Li J, Yang J, Xu Y. Choroid Plexus Papillomas of the Cerebellopontine Angle. World Neurosurg 2016; 95:117-125. [PMID: 27506402 DOI: 10.1016/j.wneu.2016.07.094] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2016] [Revised: 07/23/2016] [Accepted: 07/27/2016] [Indexed: 11/28/2022]
Abstract
OBJECTIVE Choroid plexus papillomas (CPPs) of the cerebellopontine angle (CPA) are extremely rare. We present a series of 21 cases operated on in the last 7 years at our institution. METHODS During the period from January 2008 to October 2015, we encountered 102 histologically established cases of CPPs, of which 21 were located in the CPA region. Clinical profiles, radiologic features, surgical procedures, intraoperative findings, and outcomes were extracted from the patient records and neuroimaging data. RESULTS The 21 CPPs in the CPA region accounted for 20.5% of all CPPs. Two of the tumors occurred in pediatric patients. Tumor size was 2.5-4.7 cm. The rate of calcification was higher in the CPPs in the CPA region. Peritumoral cysts and cysts with small nodules were observed in our cases. A far lateral suboccipital approach was chosen for CPPs protruding inferiorly into the foramen magnum region (n = 14), and a suboccipital retrosigmoid approach was chosen for the other tumors. Total resection was achieved in 18 patients, and subtotal resection was achieved in 3 patients. During the follow-up period, only 1 patient experienced recurrence 32 months after the first operation. The recurrence turned out to be an atypical CPP. CONCLUSIONS CPPs in the CPA region cannot be easily differentiated from other tumors preoperatively. Cysts and calcifications appear on neuroimaging. CPPs in the CPA region usually protrude inferiorly into the foramen magnum region. As much tumor should be removed as possible to avoid recurrence and malignant transition.
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Affiliation(s)
- Wei Luo
- Department of Neurosurgery, Capital Institute of Pediatrics, Chaoyang District, Beijing, China
| | - Hai Liu
- Department of Neurosurgery, China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Dongcheng District, Beijing, China.
| | - Jiaxin Li
- Department of Neurosurgery, China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Dongcheng District, Beijing, China
| | - Jun Yang
- Department of Neurosurgery, China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Dongcheng District, Beijing, China
| | - Yulun Xu
- Department of Neurosurgery, China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Dongcheng District, Beijing, China
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Du J, Wang J, Cui Y, Zhang C, Li G, Fang J, Yue S, Xu L. Clinicopathologic study of endolymphatic sac tumor (ELST) and differential diagnosis of papillary tumors located at the cerebellopontine angle. Neuropathology 2015; 35:410-20. [DOI: 10.1111/neup.12200] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2014] [Revised: 01/19/2015] [Accepted: 01/20/2015] [Indexed: 11/29/2022]
Affiliation(s)
- Jiang Du
- Department of Neuropathology; Beijing Neurosurgical Institute; Capital Medical University; China National Clinical Research Center for Neurological Diseases; NCRC-ND; Center of Brain Tumor; Beijing Institute for Brain Disorders; Beijing Key Laboratory of Brian Tumor; Beijing China
| | - Junmei Wang
- Department of Neuropathology; Beijing Neurosurgical Institute; Capital Medical University; China National Clinical Research Center for Neurological Diseases; NCRC-ND; Center of Brain Tumor; Beijing Institute for Brain Disorders; Beijing Key Laboratory of Brian Tumor; Beijing China
| | - Yun Cui
- Department of Neuropathology; Beijing Neurosurgical Institute; Capital Medical University; China National Clinical Research Center for Neurological Diseases; NCRC-ND; Center of Brain Tumor; Beijing Institute for Brain Disorders; Beijing Key Laboratory of Brian Tumor; Beijing China
| | - Cuiping Zhang
- Department of Electron Microscopy; Beijing Neurosurgical Institute; Capital Medical University; China National Clinical Research Center for Neurological Diseases; NCRC-ND; Center of Brain Tumor; Beijing Institute for Brain Disorders; Beijing Key Laboratory of Brian Tumor; Beijing China
| | - Guilin Li
- Department of Neuropathology; Beijing Neurosurgical Institute; Capital Medical University; China National Clinical Research Center for Neurological Diseases; NCRC-ND; Center of Brain Tumor; Beijing Institute for Brain Disorders; Beijing Key Laboratory of Brian Tumor; Beijing China
| | - Jingyi Fang
- Department of Neuropathology; Beijing Neurosurgical Institute; Capital Medical University; China National Clinical Research Center for Neurological Diseases; NCRC-ND; Center of Brain Tumor; Beijing Institute for Brain Disorders; Beijing Key Laboratory of Brian Tumor; Beijing China
| | - Shenglin Yue
- Department of Neuropathology; Beijing Neurosurgical Institute; Capital Medical University; China National Clinical Research Center for Neurological Diseases; NCRC-ND; Center of Brain Tumor; Beijing Institute for Brain Disorders; Beijing Key Laboratory of Brian Tumor; Beijing China
| | - Li Xu
- Department of Neuropathology; Beijing Neurosurgical Institute; Capital Medical University; China National Clinical Research Center for Neurological Diseases; NCRC-ND; Center of Brain Tumor; Beijing Institute for Brain Disorders; Beijing Key Laboratory of Brian Tumor; Beijing China
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Bian LG, Sun QF, Wu HC, Jiang H, Sun YH, Shen JK. Primary choroid plexus papilloma in the pituitary fossa: case report and literature review. Acta Neurochir (Wien) 2011; 153:851-7. [PMID: 21140177 DOI: 10.1007/s00701-010-0884-2] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2010] [Accepted: 11/12/2010] [Indexed: 11/30/2022]
Abstract
Choroid plexus papillomas are rare tumors of the central nervous system and are usually confined to the ventricular system. We illustrated a primary choroid plexus papilloma in the pituitary fossa. A 31-year-old female presented with amenorrhea and intermittent galactorrhoea, with no visual complaints in the last 2 years. Endocrine testing showed no hormone excess or deficiency of the pituitary and target glands, except for a higher prolactin level (56 ng/ml). A sharply circumscribed regular mass in the sellar region occupying the entire sella turcica and extending into the suprasellar cistern was demonstrated on MR imaging with gadolinium diethylenetriamine pentaacetic acid. The patient underwent an endonasal trans-sphenoidal approach. Complete microsurgical excision and complete preservation of the normal pituitary gland was achieved, with normal prolactin level. The histopathology showed that the lesion was a choroid plexus papilloma. Theories of the origin, the differential diagnosis, and treatment of the rare tumor are discussed.
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Affiliation(s)
- Liu-Guan Bian
- Department of Neurosurgery, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, People's Republic of China.
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Mehta VA, Bettegowda C, Singer HS, Ahn ES. Medullary cistern choroid plexus papilloma. Childs Nerv Syst 2010; 26:1825-9. [PMID: 20711595 DOI: 10.1007/s00381-010-1259-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2010] [Accepted: 07/28/2010] [Indexed: 10/19/2022]
Affiliation(s)
- Vivek A Mehta
- Division of Pediatric Neurosurgery, The Johns Hopkins Hospital, Baltimore, MD, USA
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Rapid regrowth of an atypical choroid plexus papilloma located in the cerebellopontine angle. J Clin Neurosci 2009; 16:121-4. [DOI: 10.1016/j.jocn.2008.02.021] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2008] [Revised: 02/26/2008] [Accepted: 02/27/2008] [Indexed: 11/24/2022]
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Stafrace S, Molloy J. Extraventricular choroid plexus papilloma in a neonate. Pediatr Radiol 2008; 38:593. [PMID: 18210099 DOI: 10.1007/s00247-007-0737-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2007] [Accepted: 12/16/2007] [Indexed: 11/24/2022]
Affiliation(s)
- Samuel Stafrace
- Radiology Department, Children's University Hospital, Temple Street, Dublin 1, Republic of Ireland.
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Abstract
This review article surveys clinical and pathological literature on endolymphatic sac tumours (ELST) and summarizes characteristics that describe the entity. ELST are rare neuroectodermal neoplasms in the petrous bone, originating from inner ear structures. They can be encountered sporadically or in von Hippel-Lindau disease. The most prominent symptom is sensorineural deafness. Historically, nomenclature of invasive adenoid tumours in the petrous bone has been divergent, the term papillary adenocarcinoma used most frequently. Histologically, they have a follicular or papillary and adenoid pattern that can be easily confused with various other neoplastic conditions including metastatic carcinoma. It remains to be verified whether similar tumours (papillary adenocarcinomas) can originate from the middle ear. Middle ear adenomas have a similar appearance but probably originate from neural crest cells in the middle ear. ELST can express a variety of epitopes (including cytokeratin and neuroectodermal markers) which can be detected immunohistochemically. In cases in von Hippel-Lindau disease the cerebello-pontine angle should be included in routine radiological examinations to detect ELST before the tumours lead to deafness. In apparently sporadic cases of ELST, genetic testing for von Hippel-Lindau disease should be considered. Correct distinction of ELST from metastatic carcinoma prevents futile searches for unknown primary tumours.
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Affiliation(s)
- G Kempermann
- Abteilung Neuropathologie des Pathologischen Institutes, Freiburg, Germany
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Roche PH, Dufour H, Figarella-Branger D, Pellet W. Endolymphatic sac tumors: report of three cases. Neurosurgery 1998; 42:927-32. [PMID: 9574660 DOI: 10.1097/00006123-199804000-00139] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
OBJECTIVE AND IMPORTANCE We present three cases of endolymphatic sac tumors and review the previously published cases. Despite frequent extension to the cerebellopontine angle, these rare tumors have only recently been recognized by neurosurgeons. CLINICAL PRESENTATION A 26-year-old man developed a progressive hearing loss, revealing an intrapetrous retrolabyrinthine tumor on the right side. A 28-year-old woman experienced a left cerebellopontine angle syndrome, with a lytic intrapetrous mass extending into the cerebellopontine angle. A 38-year-old woman presented with an intracranial hypertension syndrome caused by a tumor of the jugular foramen. INTERVENTION For the first and second patients, the tumors originated from the operculum of the endolymphatic sac. Total removal was achieved, via a transpetrosal approach, in these two cases. No recurrence was detected after a 20-month follow-up period. For the third patient, the tumor originated from the distal part of the sac. Recurrence was observed 8 years after subtotal removal via a retrosigmoid route. Histological analysis revealed a papillary-cystic adenocarcinomatous pattern in all cases, without features of aggressiveness. CONCLUSION Endolymphatic sac tumors are locally invasive neoplasms characterized by bipolar intrapetrous and posterior fossa involvement. The anatomic complexity of the endolymphatic sac may explain the distinct patterns of extension of these tumors. Early radical surgery is related to good outcomes.
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Affiliation(s)
- P H Roche
- Service de Neurochirurgie, Hôpital St. Marguertie, Marseille, France
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Pollak A, Böhmer A, Spycher M, Fisch U. Are papillary adenomas endolymphatic sac tumors? Ann Otol Rhinol Laryngol 1995; 104:613-9. [PMID: 7639470 DOI: 10.1177/000348949510400805] [Citation(s) in RCA: 27] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Papillary adenomas of the temporal bone have been considered as originating from the endolymphatic sac. The radiologic, surgical, and pathologic findings in a patient suffering from von Hippel-Lindau disease with bilateral papillary adenomas of the temporal bone cast some doubt on this site of origin. Radiologically, the center of tumor growth was at the top of the jugular bulb. Intraoperatively, the tumor was found to have reached the lateral wall of the endolymphatic sac, but the lumen was tumor-free. Both ciliated and nonciliated tumor cells were found in the resected tumor, resembling the ultrastructure of normal epithelial lining in the human mastoid. A strong positive immunohistochemical reaction for keratin and negative reactions for vimentin, glial fibrillary acidic protein, and S-100 protein in the tumor tissue of this patient are typical for middle ear mucosa. Therefore, the described papillary adenoma originated from the mucosa of the pneumatic spaces surrounding the jugular bulb, and the theory that the endolymphatic sac is the origin of all papillary-cystic tumors (adenocarcinomas) should be questioned.
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Affiliation(s)
- A Pollak
- Department of Otorhinolaryngology-Head and Neck Surgery, University Hospital, Zürich, Switzerland
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