Limits...
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

Case 3. Axial plain magnetic resonance imaging showing a left sided extra-axial cerebellopontine angle lesion which appears isointense and heterogeneously hyperintense on T1 and T2 sequences, respectively, with compression and deformation of the brainstem (a and b). Axial postcontrast magnetic resonance images showing homogeneous enhancement of the lesion (c)
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC4596056&req=5

Figure 4: Case 3. Axial plain magnetic resonance imaging showing a left sided extra-axial cerebellopontine angle lesion which appears isointense and heterogeneously hyperintense on T1 and T2 sequences, respectively, with compression and deformation of the brainstem (a and b). Axial postcontrast magnetic resonance images showing homogeneous enhancement of the lesion (c)

Mentions: An 8-year-old boy presented with 5 months duration of headache, vomiting, facial asymmetry, gait imbalance, and left-sided hearing loss. Neurological examination revealed bilateral papilledema, left sided abducent nerve paresis, Grade 3 LMN facial palsy, sensorineural hearing loss, and cerebellar signs. On MRI, a well-defined lobulated extra-axial left CP angle lesion was noted, appearing isointense, and heterogeneously hyperintense on T1 and T2 sequences respectively with moderate hydrocephalus and showing intense homogenous enhancement [Figure 4a-c]. A left sided retrosigmoid approach and gross total excision was performed. Child had excellent outcome after surgery and at the last follow-up of 42 months, child was doing well with no residual tumor on imaging. Histopathology was 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)

Case 3. Axial plain magnetic resonance imaging showing a left sided extra-axial cerebellopontine angle lesion which appears isointense and heterogeneously hyperintense on T1 and T2 sequences, respectively, with compression and deformation of the brainstem (a and b). Axial postcontrast magnetic resonance images showing homogeneous enhancement of the lesion (c)
© Copyright Policy - open-access
Related In: Results  -  Collection

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

Figure 4: Case 3. Axial plain magnetic resonance imaging showing a left sided extra-axial cerebellopontine angle lesion which appears isointense and heterogeneously hyperintense on T1 and T2 sequences, respectively, with compression and deformation of the brainstem (a and b). Axial postcontrast magnetic resonance images showing homogeneous enhancement of the lesion (c)
Mentions: An 8-year-old boy presented with 5 months duration of headache, vomiting, facial asymmetry, gait imbalance, and left-sided hearing loss. Neurological examination revealed bilateral papilledema, left sided abducent nerve paresis, Grade 3 LMN facial palsy, sensorineural hearing loss, and cerebellar signs. On MRI, a well-defined lobulated extra-axial left CP angle lesion was noted, appearing isointense, and heterogeneously hyperintense on T1 and T2 sequences respectively with moderate hydrocephalus and showing intense homogenous enhancement [Figure 4a-c]. A left sided retrosigmoid approach and gross total excision was performed. Child had excellent outcome after surgery and at the last follow-up of 42 months, child was doing well with no residual tumor on imaging. Histopathology was 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