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Case series of choroid plexus papilloma in children at uncommon locations and review of the literature.

Prasad GL, Mahapatra AK - Surg Neurol Int (2015)

Bottom Line: Two cases presented with features of obstructive hydrocephalus while the latter presented with compressive effects.Complete removal leads to excellent long-term survival rates.Adjuvant treatment is not required.

View Article: PubMed Central - PubMed

Affiliation: Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India.

ABSTRACT

Background: Choroid plexus papillomas (CPPs) comprise around 1% of intracranial neoplasms. The most common location is atrium of the lateral ventricle in children and fourth ventricle in adults. Other rare locations include third ventricle, cerebellopontine (CP) angle and cerebral parenchyma, with only a few cases reported. Authors report three cases of CPP at uncommon locations in pediatric patients. The rarity of these locations, diagnostic dilemma and management aspects are discussed along with an extensive review of the literature.

Methods: Retrospective institutional data analysis of histopathologically confirmed pediatric CPPs from 2010 to 2014.

Results: Authors noted three cases of CPP in children in uncommon locations-one each in the posterior third ventricle, fourth ventricle, and CP angle. All were males in the first decade. Two cases presented with features of obstructive hydrocephalus while the latter presented with compressive effects. Complete excision was achieved in two cases while subtotal removal was performed in one case (fourth ventricular) because of excess blood loss. Mean follow-up duration was 24.6 months (range 20-30 months). One case (of subtotal removal) had fair recovery while other two had excellent outcomes.

Conclusions: Posterior third ventricle, fourth ventricle, and CP angle are uncommon locations for these tumors in children. Complete surgical removal is the treatment of choice and approach needs to be tailored according to the site and size of the lesion. Blood loss is a major concern in young children as they are highly vascular tumors. Complete removal leads to excellent long-term survival rates. Adjuvant treatment is not required.

No MeSH data available.


Related in: MedlinePlus

Histopathological images showing a papillary tumor with smooth papillae lined by single layer of columnar cells with no mitosis (a). Immunohistochemical images staining for pancytokeratin and synaptophysin were positive (b and c) while being negative for epithelial membrane antigen (d). Features were compatible with choroid plexus papilloma
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Figure 2: Histopathological images showing a papillary tumor with smooth papillae lined by single layer of columnar cells with no mitosis (a). Immunohistochemical images staining for pancytokeratin and synaptophysin were positive (b and c) while being negative for epithelial membrane antigen (d). Features were compatible with choroid plexus papilloma

Mentions: Histopathology showed a papillary tumor lined by columnar epithelium with centrally placed nuclei. There was no mitosis or necrosis [Figure 2a]. Tumor stained positive for pancytokeratin and synaptophysin [Figure 2b and c] while epithelial membrane antigen (EMA) staining was negative [Figure 2d]. Overall findings were suggestive of CPP.


Case series of choroid plexus papilloma in children at uncommon locations and review of the literature.

Prasad GL, Mahapatra AK - Surg Neurol Int (2015)

Histopathological images showing a papillary tumor with smooth papillae lined by single layer of columnar cells with no mitosis (a). Immunohistochemical images staining for pancytokeratin and synaptophysin were positive (b and c) while being negative for epithelial membrane antigen (d). Features were compatible with choroid plexus papilloma
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4596056&req=5

Figure 2: Histopathological images showing a papillary tumor with smooth papillae lined by single layer of columnar cells with no mitosis (a). Immunohistochemical images staining for pancytokeratin and synaptophysin were positive (b and c) while being negative for epithelial membrane antigen (d). Features were compatible with choroid plexus papilloma
Mentions: Histopathology showed a papillary tumor lined by columnar epithelium with centrally placed nuclei. There was no mitosis or necrosis [Figure 2a]. Tumor stained positive for pancytokeratin and synaptophysin [Figure 2b and c] while epithelial membrane antigen (EMA) staining was negative [Figure 2d]. Overall findings were suggestive of CPP.

Bottom Line: Two cases presented with features of obstructive hydrocephalus while the latter presented with compressive effects.Complete removal leads to excellent long-term survival rates.Adjuvant treatment is not required.

View Article: PubMed Central - PubMed

Affiliation: Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India.

ABSTRACT

Background: Choroid plexus papillomas (CPPs) comprise around 1% of intracranial neoplasms. The most common location is atrium of the lateral ventricle in children and fourth ventricle in adults. Other rare locations include third ventricle, cerebellopontine (CP) angle and cerebral parenchyma, with only a few cases reported. Authors report three cases of CPP at uncommon locations in pediatric patients. The rarity of these locations, diagnostic dilemma and management aspects are discussed along with an extensive review of the literature.

Methods: Retrospective institutional data analysis of histopathologically confirmed pediatric CPPs from 2010 to 2014.

Results: Authors noted three cases of CPP in children in uncommon locations-one each in the posterior third ventricle, fourth ventricle, and CP angle. All were males in the first decade. Two cases presented with features of obstructive hydrocephalus while the latter presented with compressive effects. Complete excision was achieved in two cases while subtotal removal was performed in one case (fourth ventricular) because of excess blood loss. Mean follow-up duration was 24.6 months (range 20-30 months). One case (of subtotal removal) had fair recovery while other two had excellent outcomes.

Conclusions: Posterior third ventricle, fourth ventricle, and CP angle are uncommon locations for these tumors in children. Complete surgical removal is the treatment of choice and approach needs to be tailored according to the site and size of the lesion. Blood loss is a major concern in young children as they are highly vascular tumors. Complete removal leads to excellent long-term survival rates. Adjuvant treatment is not required.

No MeSH data available.


Related in: MedlinePlus