Case of the month. May 1996--hydrocephalus in a 9 month old infant

Cystic choroid plexus papilloma with multiple mural nodules in an infant

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.

Gliosarcoma with melanocytic differentiation

We present an unusual case of gliosarcoma containing numerous islands of well-differentiated melanocytes in a 65 year-old man. Melanocytic differentiation of medulloblastomas is well described, and it has also rarely been reported in low-grade glial neoplasms. Histologic features and immunophenotyping are helpful in differentiating divergent differentiation in a gliosarcoma from melanoma. To our knowledge, this is the first description of a gliosarcoma with melanocytic differentiation. Awareness of the phenomenon of melanocytic differentiation within primary neuroepithelial and glial neoplasms is important to prevent the misdiagnosis of these tumors such as metastatic melanoma or primary melanocytic neoplasms of the CNS.