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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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2
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Wendt SP, Raviskanthan S, Mortensen PW, Lee AG. Intermittent Syncope and Downbeat Nystagmus in Fourth Ventricle Choroid Plexus Papilloma. J Neuroophthalmol 2023; 43:e328-e330. [PMID: 35234681 DOI: 10.1097/wno.0000000000001492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Sydney P Wendt
- Baylor College of Medicine (SPW), Houston, Texas; Department of Ophthalmology (SR, PWM), Blanton Eye Institute, Houston Methodist Hospital, Houston, Texas; Departments of Ophthalmology, Neurology, and Neurosurgery (AGL), Weill Cornell Medicine, New York, New York; Department of Ophthalmology (AGL), University of Texas Medical Branch, Galveston, Texas; University of Texas MD Anderson Cancer Center (AGL), Houston, Texas; Texas A and M College of Medicine (AGL), Bryan, Texas; and Department of Ophthalmology (AGL), The University of Iowa Hospitals and Clinics, Iowa City, Iowa
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Singh SK, Patra S, Shirazi N, Gupta G. Extracerebral choroid plexus papilloma in a newborn: a rare presentation. BMJ Case Rep 2023; 16:e256794. [PMID: 37996145 PMCID: PMC10668134 DOI: 10.1136/bcr-2023-256794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2023] Open
Abstract
Choroid plexus papillomas (CPPs) are extremely rare lesions that originate in the central nervous system. Still rarely, these can occur in heterotopic locations. We report a case of aneonate who presented at fourth week of life with a small swelling in the left side of the oropharynx. There were no other symptoms. MRI scan revealed a cystic lesion with the possibility of lymphatic malformation or teratoma. Swelling which was gradually increasing in size was electively excised. Histopathological examination revealed it to be an extracerebral CPP. Postoperative period was uneventful, and baby had no further complications. CPP is a rare lesion and, almost always, cannot be anticipated before surgery. Imaging only helps in surgical planning. Complete excision is curative.
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Affiliation(s)
- Santosh Kumar Singh
- Paediatric Surgery, Himalayan Institute of Medical Sciences, Dehradun, India
| | - Saikat Patra
- Neonatology, Himalayan Institute of Medical Sciences, Dehradun, India
| | - Nadia Shirazi
- Pathology, Himalayan Institute of Medical Sciences, Dehradun, India
| | - Girish Gupta
- Neonatology, Himalayan Institute of Medical Sciences, Dehradun, India
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Pongeluppi RI, Ballestero MFM, Santos MV, Oliveira RSD. Posterior fossa choroidplexus papilloma in the pediatric population: case series and literature review. ARQUIVOS DE NEURO-PSIQUIATRIA 2023; 81:825-834. [PMID: 37604205 PMCID: PMC10550351 DOI: 10.1055/s-0043-1770351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Accepted: 02/09/2023] [Indexed: 08/23/2023]
Abstract
Choroid plexus papillomas (CPPs) are rare benign neoplasms which are particularly uncommon in the posterior fossa in children. We herein present a case series of five patients treated at a tertiary care hospital. A comprehensive literature review was also carried out. The patients treated at the tertiary care hospital were aged between 4 and 16 years. Gross total resection (GTR) was initially achieved in two patients. All patients showed clinical improvement. Moreover, 27 articles published between 1975 and 2021 were selected for the literature review, totaling 46 patients; with the 5 patients previously described, the total sample was composed of 51 cases, With a mean age was 8.2 years. The lesions were located either in the fourth ventricle (65.3%) or the cerebellopontine angle (34.7%). Hydrocephalus was present preoperatively in 66.7% of the patients, and a permanent shunt was required in 31.6% of the cases. The GTR procedure was feasible in 64.5%, and 93.8% showed clinical improvement. For CPPs, GTR is the gold standard treatment and should be attempted whenever feasible, especially because the role of the adjuvant treatment remains controversial. Neuromonitoring is a valuable tool to achieve maximal safe resection. Hydrocephalus is common and must be recognized and promptly treated. Most patients will need a permanent shunt. Though there is still controversy on its efficacy, endoscopic third ventriculostomy is a safe procedure, and was the authors' first choice to treat hydrocephalus.
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Affiliation(s)
- Rodrigo Inácio Pongeluppi
- Universidade de São Paulo, Faculdade de Medicina de Ribeirão Preto, Hospital das Clínicas, Divisão de Neurocirurgia, Ribeirão Preto SP, Brazil.
| | - Matheus Fernando Manzolli Ballestero
- Universidade de São Paulo, Faculdade de Medicina de Ribeirão Preto, Hospital das Clínicas, Divisão de Neurocirurgia, Ribeirão Preto SP, Brazil.
- Universidade Federal de São Carlos, Departamento de Medicina, São Carlos SP, Brazil.
| | - Marcelo Volpon Santos
- Universidade de São Paulo, Faculdade de Medicina de Ribeirão Preto, Hospital das Clínicas, Divisão de Neurocirurgia, Ribeirão Preto SP, Brazil.
| | - Ricardo Santos de Oliveira
- Universidade de São Paulo, Faculdade de Medicina de Ribeirão Preto, Hospital das Clínicas, Divisão de Neurocirurgia, Ribeirão Preto SP, Brazil.
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Li W, Li Z, Wei C, Yang X, Ji Y, Liu H. Microscopic and endoscopic "chopstick" technique removal of choroid plexus papilloma in the third ventricle of an infant: a case report with systematic review of literature. Front Oncol 2023; 13:1182261. [PMID: 37434973 PMCID: PMC10332163 DOI: 10.3389/fonc.2023.1182261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Accepted: 06/12/2023] [Indexed: 07/13/2023] Open
Abstract
Background Choroid plexus papilloma (CPP) is rare and even rarer in infants and young children, and it usually occurs in the ventricles. Due to the physical peculiarities of infants, tumor removal by microscopic or endoscopic surgery alone is difficult. Case Presentation A 3-month-old patient was found to have an abnormally enlarged head circumference for 7 days. Cranial magnetic resonance imaging (MRI) examination revealed a lesion in the third ventricle. The patient underwent combined microscopic and endoscopic "chopstick" technique to remove the tumor. He recovered well after the surgery. Postoperative pathological examination revealed CPP. Postoperative MRI suggested total resection of the tumor. Follow-up for 1 month showed no recurrence or distant metastasis. Conclusions Combined microscopic and endoscopic "chopstick" technique may be a suitable approach to remove tumors in infant ventricles.
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Affiliation(s)
- Weiwei Li
- Department of Neurosurgery, Jiange People’s Hospital, Jiange, Sichuan, China
| | - Zongping Li
- Department of Neurosurgery, Mianyang Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Mianyang, Sichuan, China
| | - Chengyan Wei
- Department of Neurosurgery, Jiange People’s Hospital, Jiange, Sichuan, China
| | - Xiaoyong Yang
- Department of Neurosurgery, Jiange People’s Hospital, Jiange, Sichuan, China
| | - Yuzhu Ji
- Department of Pathology, Mianyang Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Mianyang, Sichuan, China
| | - Hongyuan Liu
- Department of Neurosurgery, Jiange People’s Hospital, Jiange, Sichuan, China
- Department of Neurosurgery, Mianyang Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Mianyang, Sichuan, China
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Zhou F, Li Y, Shen L, Yao H, Hou X. Infantile epileptic spasms syndrome as an initial presentation in infantile choroid plexus papilloma: A case report. Front Pediatr 2022; 10:1035621. [PMID: 36467493 PMCID: PMC9709204 DOI: 10.3389/fped.2022.1035621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2022] [Accepted: 10/18/2022] [Indexed: 11/18/2022] Open
Abstract
We present an interesting report of a 5-month-old infant with epileptic spasms and developmental delay who presented with non-isolated ventriculomegaly in utero and whose brain magnetic resonance imaging revealed right ventricular choroid plexus papilloma (CPP). The epileptic spasms persisted even with the use of antiepileptic therapies but was apparently cured after the removal of a CPP.
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Affiliation(s)
- Faliang Zhou
- Department of Pediatrics, Peking University First Hospital, Beijing, China
| | - Yu Li
- Department of Pediatric Surgery, Peking University First Hospital, Beijing, China
| | - Lixue Shen
- Department of Pediatric Surgery, Peking University First Hospital, Beijing, China
| | - Hongxin Yao
- Department of Pediatric Surgery, Peking University First Hospital, Beijing, China
| | - Xinlin Hou
- Department of Pediatrics, Peking University First Hospital, Beijing, China
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Basindwah SA, Alzahrani BS, Ajlan AM, Alkhalidi H. Persistence of communicating hydrocephalus post choroid plexus tumor resection: Case reports and review of literature. Surg Neurol Int 2021; 12:483. [PMID: 34754533 PMCID: PMC8571326 DOI: 10.25259/sni_681_2021] [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: 07/09/2021] [Accepted: 08/27/2021] [Indexed: 11/04/2022] Open
Abstract
Background Hydrocephalus is the most common presentation of choroid plexus tumors; it is thought to be caused either by mass effect obstructing the cerebrospinal fluid pathways or secretory properties of the tumor. In these case reports, we present two cases of choroid plexus tumors with persistence of communicating hydrocephalus postoperatively and review similar reports in the literature. Case Description Case 1: a 2-month-old baby girl presented with bulging fontanelle, sunsetting eyes. Magnetic resonance imaging (MRI) showed large third ventricle mass with communicating hydrocephalus. She underwent complete excision of tumor through transcortical approach with perioperative intraventricular hemorrhage. Hydrocephalus persisted postoperatively and the patient required permanent ventriculoperitoneal (VP) shunt. Case 2: a 16-year-old boy presented decreased visual acuity, papilledema, and morning headaches. MRI showed a tumor in the right ventricle and communicating hydrocephalus. He underwent transparietal resection of the tumor. In both cases, hydrocephalus persisted postoperatively and patients required permanent VP shunt. Review of similar cases showed the majority of cases required permanent shunting. Conclusion Choroid plexus tumor patients can present with communicating hydrocephalus that may persist post tumor resection for different etiologies. Careful follow-up to determine the need for cerebrospinal fluid diversion through a permanent VP shunt is important.
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Affiliation(s)
- Sarah A Basindwah
- Department of Surgery, Division of Neurosurgery, King Saud University, Riyadh, Saudi Arabia
| | - Basmah S Alzahrani
- Department of Surgery, Imam Abdulrahman Bin Faisal University, Al-Khobar, Eastern Province, Saudi Arabia
| | - Abdulrazag M Ajlan
- Department of Surgery, Division of Neurosurgery, King Saud University, Riyadh, Saudi Arabia
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Gaddi MJS, Lappay JI, Chan KIP, Pascual JSG, Salonga AEM. Pediatric choroid plexus papilloma arising from the cerebellopontine angle: systematic review with illustrative case. Childs Nerv Syst 2021; 37:799-807. [PMID: 32980905 DOI: 10.1007/s00381-020-04896-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Accepted: 09/22/2020] [Indexed: 10/23/2022]
Abstract
INTRODUCTION Choroid plexus tumors are uncommon intraventricular tumors that develop from the choroid plexus of the central nervous system. Choroid plexus papillomas arising from the cerebellopontine angle have been reported to almost exclusively occur in adults and are rarely found in children. METHODS We report a systematic review conducted in accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines of SCOPUS and PubMed databases for case reports and case series of choroid plexus papillomas arising in the cerebellopontine angle in the pediatric population and discuss clinical presentation, imaging features, management options, and outcomes. We also report a case managed at our center. RESULTS Ten cases of pediatric choroid plexus papillomas arising in the cerebellopontine angle were identified from the systematic review in addition to the case reported here, resulting in a total of eleven cases. The patients' median age was 8 years with a slight female sex predilection (1.2:1). Patients most commonly presented with headache, cerebellar signs, and cranial nerve palsies with median duration of symptoms at 4 months. All patients underwent surgical treatment with majority achieving gross total excision. No deaths were reported at median follow-up of 12 months. Complete neurologic recovery was attained in seven cases while partial recovery was seen in two cases. CONCLUSION Choroid plexus papillomas found in the cerebellopontine angle in the pediatric population are extremely rare but they should be considered in the differential diagnosis. Complete surgical resection is the mainstay of treatment with excellent outcomes achievable in majority of patients.
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Affiliation(s)
- Mairre James S Gaddi
- Division of Neurosurgery, Department of Neurosciences, University of the Philippines - Philippine General Hospital, Manila, Philippines.
| | - Jeffrey I Lappay
- Division of Pediatric Neurology, Department of Neurosciences and Pediatrics, University of the Philippines - Philippine General Hospital, Manila, Philippines
| | - Kevin Ivan P Chan
- Division of Neurosurgery, Department of Neurosciences, University of the Philippines - Philippine General Hospital, Manila, Philippines
| | - Juan Silvestre G Pascual
- Division of Neurosurgery, Department of Neurosciences, University of the Philippines - Philippine General Hospital, Manila, Philippines
| | - Alaric Emmanuel M Salonga
- Division of Neurosurgery, Department of Neurosciences, University of the Philippines - Philippine General Hospital, Manila, Philippines
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Bansal S, Satapathy A, Purkait S, Sahu RN. Shunt Ascites in a Fourth Ventricular Choroid Plexus Papilloma in a Young Child: An Uncommon Case. J Pediatr Neurosci 2020; 15:338-340. [PMID: 33531966 PMCID: PMC7847129 DOI: 10.4103/jpn.jpn_69_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2019] [Revised: 11/18/2019] [Accepted: 03/29/2020] [Indexed: 12/01/2022] Open
Affiliation(s)
- Sumit Bansal
- Department of Neurosurgery, All India Institute of Medical Sciences (AIIMS), Bhubaneswar, Orissa, India
| | - Ayusman Satapathy
- Department of Neurosurgery, All India Institute of Medical Sciences (AIIMS), Bhubaneswar, Orissa, India
| | - Suvendu Purkait
- Department of Pathology and Lab Medicine, All India Institute of Medical Sciences (AIIMS), Bhubaneswar, Orissa, India
| | - Rabi Narayan Sahu
- Department of Neurosurgery, All India Institute of Medical Sciences (AIIMS), Bhubaneswar, Orissa, India
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Lee N, Bae MH, Han YM, Park KH, Hwang JY, Hwang CS, Lee JC, Byun SY. Extracerebral choroid plexus papilloma in the pharynx with airway obstruction in a newborn: a case report. BMC Pediatr 2020; 20:336. [PMID: 32635904 PMCID: PMC7339594 DOI: 10.1186/s12887-020-02234-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Accepted: 07/01/2020] [Indexed: 11/28/2022] Open
Abstract
Background Choroid plexus papillomas (CPPs) are rare, usually benign, neoplasms originating in the central nervous system. In this study, we present the first case of a giant airway-obstructing CPP in the pharynx of a newborn. Case presentation A cystic mass located in the pharynx was noted in a fetus at the 29th week of gestation. Elective cesarean section was performed at the 38th week of gestation with successful intubation and ex utero intrapartum treatment. On computed tomography, there was a huge airway-obstructing cystic mass in the choana and pharynx. Elective surgery with total excision was performed, and histological examination confirmed the diagnosis of CPP. Conclusion We report the first case of an extracerebral airway-obstructing CPP in the pharynx of a newborn. Radiologic examinations are not enough for the diagnosis of CPPs, and complete excision of the tumor with histological confirmation is indispensable for accurate diagnosis and treatment.
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Affiliation(s)
- Narae Lee
- Department of Pediatrics, Pusan National University School of Medicine, 20 Geumo-ro, Yangsan, 50612, Republic of Korea
| | - Mi Hye Bae
- Department of Pediatrics, Pusan National University School of Medicine, 20 Geumo-ro, Yangsan, 50612, Republic of Korea
| | - Young Mi Han
- Department of Pediatrics, Pusan National University School of Medicine, 20 Geumo-ro, Yangsan, 50612, Republic of Korea
| | - Kyung Hee Park
- Department of Pediatrics, Pusan National University School of Medicine, 20 Geumo-ro, Yangsan, 50612, Republic of Korea
| | - Jae-Yeon Hwang
- Department of Radiology, Pusan National University School of Medicine, Yangsan, Republic of Korea
| | - Cheong-Soo Hwang
- Department of Pathology, Pusan National University School of Medicine, Yangsan, Republic of Korea
| | - Jin-Choon Lee
- Department of Otorhinolaryngology and Head-neck surgery, Pusan National University School of Medicine, Yangsan, Republic of Korea
| | - Shin Yun Byun
- Department of Pediatrics, Pusan National University School of Medicine, 20 Geumo-ro, Yangsan, 50612, Republic of Korea.
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Trybula SJ, Karras C, Bowman RM, Alden TD, DiPatri AJ, Tomita T. Infratentorial choroid plexus tumors in children. Childs Nerv Syst 2020; 36:1761-1766. [PMID: 32123998 PMCID: PMC7355280 DOI: 10.1007/s00381-020-04532-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2019] [Accepted: 02/07/2020] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Choroid plexus tumors (CPTs) are rare pediatric intracranial neoplasms, and mostly occur in the lateral ventricle. CPTs located in the infratentorial location are considered to be rare in the pediatric population. We present a series of eight patients treated in the last decade at our institution focusing on clinical presentations and their outcome after excision. METHODS We performed an institutional retrospective review of patients who underwent surgical resection of infratentorial CPTs during the period from 2008 to 2017. Patients' charts were reviewed for demographic data, clinical presentation, surgical treatment, and follow-up. RESULTS There were eight patients (6 females and 2 males), with mean age for the cohort at presentation was 9.0 years. They represent 75% of 12 CPTs of all locations treated at the same period in our institution. These 8 infratentorial CPTs were in the fourth ventricle in seven, and in the cerebellopontine angle (CPA) in one. Seven patients had choroid plexus papillomas (WHO grade I) and 1 had an atypical choroid plexus papilloma (WHO grade II). Gross total resection was attempted in all patients. However, two of 3 patients with fourth ventricle floor invasion had subtotal resection with a thin layer of tumor left on the floor. The remaining 6 had a gross total resection. Six patients with preoperative hydrocephalus had a perioperative external ventricular drainage but none required permanent shunting after tumor resection. None showed recurrence/tumor progression without adjuvant therapy during the follow-up period of 20 months to 11 years. CONCLUSION Infratentorial dominance among pediatric CPTs in this series contradicts previous reports. Infratentorial CPTs are amenable to surgical resection. Unresected small residuals due to invasion to the fourth ventricle floor showed no regrowth during 2 to 3 years follow-up without adjuvant therapy. However, these patients with incomplete resection need watchful observations.
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Affiliation(s)
- S. Joy Trybula
- grid.16753.360000 0001 2299 3507Division of Pediatric Neurosurgery, Ann & Robert H. Lurie Children’s Hospital of Chicago, Northwestern University Feinberg School of Medicine, 225 E. Chicago Avenue, Chicago, IL USA
| | - Constantine Karras
- grid.16753.360000 0001 2299 3507Division of Pediatric Neurosurgery, Ann & Robert H. Lurie Children’s Hospital of Chicago, Northwestern University Feinberg School of Medicine, 225 E. Chicago Avenue, Chicago, IL USA
| | - Robin M. Bowman
- grid.16753.360000 0001 2299 3507Division of Pediatric Neurosurgery, Ann & Robert H. Lurie Children’s Hospital of Chicago, Northwestern University Feinberg School of Medicine, 225 E. Chicago Avenue, Chicago, IL USA
| | - Tord D. Alden
- grid.16753.360000 0001 2299 3507Division of Pediatric Neurosurgery, Ann & Robert H. Lurie Children’s Hospital of Chicago, Northwestern University Feinberg School of Medicine, 225 E. Chicago Avenue, Chicago, IL USA
| | - Arthur J. DiPatri
- grid.16753.360000 0001 2299 3507Division of Pediatric Neurosurgery, Ann & Robert H. Lurie Children’s Hospital of Chicago, Northwestern University Feinberg School of Medicine, 225 E. Chicago Avenue, Chicago, IL USA
| | - Tadanori Tomita
- Division of Pediatric Neurosurgery, Ann & Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, 225 E. Chicago Avenue, Chicago, IL, USA.
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Stoyanov GS, Petkova L, Dzhenkov DL. A Practical Approach to the Differential Diagnosis of Intracranial Tumors: Gross, Histology, and Immunoprofile-based Algorithm. Cureus 2019; 11:e6384. [PMID: 31938662 PMCID: PMC6957037 DOI: 10.7759/cureus.6384] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Accepted: 12/15/2019] [Indexed: 12/22/2022] Open
Abstract
Intracranial tumors are a diverse group of conditions, both benign and malignant, primary and metastatic and always require detailed medical information, radiological reports and deep knowledge of the histological hallmarks and immunohistochemical profile of different types of tumors and tumor-like processes. Despite it clinically often being possible to differentiate between primary and metastatic tumors, based on the tumor location and age of the patient, histological variants and rare tumor entries should always be considered in the histological differential diagnosis. A thorough diagnostic algorithm based on the location of the tumor and its histological features, together with some common pitfalls in immunohistochemical profiling, based on the 2016 revised World Health Organization (WHO) classification of tumors of the central nervous system should be implemented in all cases. Such an algorithm is especially valuable in cases where only small tumor fragments are sent for morphological evaluation, such as in deep parenchyma tumors. In these instances where only small fragments of the tumor are present for histology, some key features, corresponding to the WHO grade, may easily be missed or underreported. Furthermore, the histological verification of the tumor entry is the first, often overlooked, step in defining the presence or absence of WHO grade-specific mutations.
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Affiliation(s)
- George S Stoyanov
- General and Clinical Pathology, Forensic Medicine and Deontology, Medical University of Varna, Varna, BGR
| | - Lilyana Petkova
- General and Clinical Pathology, Forensic Medicine and Deontology, Medical University of Varna, Varna, BGR
| | - Deyan L Dzhenkov
- General and Clinical Pathology, Forensic Medicine and Deontology, Medical University of Varna, Varna, BGR
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Castro Castro J, Lista Martínez O, Cuevas Álvarez EC, Iglesias Meleiro JM, Pérez López C. Choroid plexus papilloma of the third ventricle. A case report. Neurocirugia (Astur) 2019; 31:151-154. [PMID: 31401052 DOI: 10.1016/j.neucir.2019.06.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2019] [Accepted: 06/24/2019] [Indexed: 10/26/2022]
Abstract
Choroid plexus papilloma is an uncommon tumour of the central nervous system, accounting for less than 1% of all intracranial neoplasm. The usual locations are the lateral ventricle in infants and children and the fourth ventricle in adults. The third ventricle is a rare location, with few cases reported in the literature. We describe the case of a 3-month-old boy who was admitted to our centre with signs of raised intracranial pressure. Neuroimaging studies showed a third ventricular mass with associated hydrocephalus. The patient underwent complete tumour removal through a transfrontal approach and ventriculo-peritoneal shunt surgery. Postoperative course of the child was uneventful and follow-up magnetic resonance imaging revealed no residual tumour. Histopathology of the resected lesion confirmed the diagnosis of choroid plexus papilloma. We discuss the clinical, radiological and histological features of this infrequent type of tumours.
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Affiliation(s)
- Julián Castro Castro
- Servicio de Neurocirugía, Complexo Hospitalario Universitario de Ourense, Orense, España.
| | - Olalla Lista Martínez
- Servicio de Neurocirugía, Complexo Hospitalario Universitario de Ourense, Orense, España
| | | | | | - Cristina Pérez López
- Servicio de Radiodiagnóstico, Complexo Hospitalario Universitario de Ourense, Orense, España
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Muñoz Montoya JE, Maldonado Moran MA, Santamaria Rodriguez P, Toro Lopez S, Perez Cataño CS, Luque Suarez JC. Choroid Plexus Papilloma of the Fourth Ventricle: A Pediatric Patient. Asian J Neurosurg 2019; 14:585-588. [PMID: 31143290 PMCID: PMC6516030 DOI: 10.4103/ajns.ajns_301_18] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Choroid plexus papilloma is a low-frequency entity in both the adult and pediatric populations. Its clinical presentation is very variable as it depends on its location and length. We must always do the differential diagnosis between papilloma and other intraventricular pathologies. This article is about a case report of a pediatric patient with a Choroid plexus papilloma located in the fourth ventricle, a location that is atypical for the pediatric population.
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Affiliation(s)
| | | | | | - Sebastian Toro Lopez
- Departament of Neurosurgery, Universidad Militar Nueva Granada, Bogotá, Colombia
| | | | - Juan Carlos Luque Suarez
- Neurosurgeon, Departament of Neurosurgery, Universidad Militar Nueva Granada, Hospital Militar Central, Bogotá, Colombia
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Stoyanov GS, Kobakova I, Stoyanov D, Zhelezov M, Angelova M, Dzhenkov D, Georgieva R, Ayetola L, Kovachev E, Ghenev P, Tonchev AB. Early Second-Trimester Spontaneous Miscarriage Due to Fourth Ventricle Choroid Plexus Papilloma. JOURNAL OF FETAL MEDICINE 2018. [DOI: 10.1007/s40556-018-0175-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
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16
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Khade S, Shenoy A. Ectopic Choroid Plexus Papilloma. Asian J Neurosurg 2018; 13:191-194. [PMID: 29492159 PMCID: PMC5820885 DOI: 10.4103/1793-5482.185067] [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] [Indexed: 11/04/2022] Open
Abstract
Choroid plexus papilloma is a rare intracranial neoplasm. These lesions most commonly present in the fourth ventricle in adults and lateral ventricle in children. Herein, we report a case of a 57-year-old male with complaint of backache of few weeks duration. Magnetic resonance imaging revealed an intradural and extramedullary space occupying lesion at D8 level. Histology showed multiple free-floating papillae with a central fibrovascular core. The cells showed immunoreactivity for vimentin, glial fibrillary acidic protein, synaptophysin, S-100 protein, and cytokeratins (CK, CK7).
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Affiliation(s)
- Shalaka Khade
- Department of Pathology, Topiwala National Medical College and BYL Nair Charitable Hospital, Mumbai, Maharashtra, India
| | - Asha Shenoy
- Department of Pathology, Topiwala National Medical College and BYL Nair Charitable Hospital, Mumbai, Maharashtra, India
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Cao LR, Chen J, Zhang RP, Hu XL, Fang YL, Cai CQ. Choroid Plexus Papilloma of Bilateral Lateral Ventricle in an Infant Conceived by in vitro Fertilization. Pediatr Neurosurg 2018; 53:401-406. [PMID: 30391955 DOI: 10.1159/000491639] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2018] [Accepted: 06/28/2018] [Indexed: 11/19/2022]
Abstract
Choroid plexus papilloma (CPP) is a rare benign tumor of the central nervous system. Bilateral lateral ventricle CPP is extremely uncommon. In this case report, we described a case of bilateral lateral ventricle CPP in a 4-month-old female patient conceived by in vitro fertilization (IVF). Neurological examination and imaging were performed. In neurological examination, meningeal irritation signs and sunset phenomenon were positive. Brain computed tomography (CT) and magnetic resonance imaging (MRI) displayed masses located in the trigone of the bilateral lateral ventricle with hydrocephalus. Contrast-enhanced MRI showed intense homogeneous enhancement. The diagnoses of bilateral lateral ventricle CPP related to hydrocephalus and extravasation of cerebrospinal fluid (CSF) were made. Repeated surgical procedures via parietotemporal craniotomy were performed, and the diagnosis was confirmed by histopathology examination. The patient presented with delayed development during a follow-up period of 1 year. In conclusion, imaging is an effective approach of investigation. CPP could be highly suspected according to the features of hydrocephalus, lobulated appearance, and homogeneous enhancement on imaging. Total surgical removal is a valid curative method for CPP.
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Affiliation(s)
- Li-Rong Cao
- Graduate College of Tianjin Medical University, Tianjin, China
| | - Jing Chen
- Department of Radiology, Tianjin Children's Hospital, Tianjin, China
| | | | - Xiao-Li Hu
- Department of Pathology, Tianjin Children's Hospital, Tianjin, China
| | - Yu-Lian Fang
- Institute of Pediatrics, Tianjin Children's Hospital, Tianjin, China
| | - Chun-Quan Cai
- Department of Neurosurgery, Tianjin Children's Hospital, Tianjin, China,
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Godar DE, Merrill SJ. Untangling the most probable role for vitamin D 3 in autism. DERMATO-ENDOCRINOLOGY 2017; 9:e1387702. [PMID: 29484101 PMCID: PMC5821151 DOI: 10.1080/19381980.2017.1387702] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/15/2017] [Revised: 09/02/2017] [Accepted: 09/29/2017] [Indexed: 12/31/2022]
Abstract
Recent studies indicate an important role for vitamin D3 in autism spectrum disorder (ASD), although its mechanism is not completely understood. The most puzzling aspect of ASD is that identical twins, who share identical DNA, do not have 100% concordance rates (∼88% for identical and ∼31% for fraternal twins). These findings provide major clues into the etiology: ASD must involve an environmental factor present in the prenatal milieu that both identical twins are not always exposed to because they do not always share it (i.e., placentas). Combined with the exponential increasing rates of ASD around the world, these observations suggest a contagious disease is probably transferred to the fetus via the placenta becoming infected by a cervical virus. Vitamin D3 boosts immune responses clearing viral infections and increases serotonin and estrogen brain levels. Here we review the different roles and untangle the most probable one vitamin D3 plays in ASD.
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Affiliation(s)
- Dianne E. Godar
- Body of Knowledge, Inc., Division of Human Disease Research Worldwide, Racine, WI, USA
| | - Stephen J. Merrill
- Marquette University, Department of Mathematics, Statistics, and Computer Science, Milwaukee, WI, USA
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