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Lateral ventricle choroid plexus papilloma in childhood: management and complications
1Neurosurgical Associates, Ltd., Minneapolis, Minnesota, USA.
Insights
Pediatric choroid plexus papilloma in the lateral ventricle presents with developmental delays. Surgical approaches combined with external ventricular drainage may prevent complications like subdural effusions.
Area of Science:
- Pediatric neurosurgery
- Neuroradiology
- Pediatric oncology
Background:
- Choroid plexus papilloma (CPP) is a rare tumor affecting the lateral ventricles in children.
- This review focuses on CPP in pediatric patients under 8 years old, excluding other locations and choroid plexus carcinoma.
- The study analyzes clinical features, imaging, surgical approaches, and complications in a selected cohort.
Observation:
- Developmental delays and regression were the most common clinical manifestations in pediatric CPP.
- Magnetic resonance imaging (MRI) is the preferred diagnostic modality for lateral ventricle CPP.
- Magnetic resonance angiography (MRA) can replace conventional angiography, and tumor embolization attempts were unsuccessful.
Findings:
- An intersulcal splitting approach to the lateral ventricular trigone was utilized.
- Perioperative external ventricular drainage was employed in conjunction with surgical resection.
- Total tumor resection was confirmed by preoperative and postoperative imaging studies.
Implications:
- The described surgical technique and perioperative management may help avoid symptomatic subdural effusions.
- Early diagnosis and appropriate surgical intervention are crucial for managing pediatric choroid plexus papilloma.
- Further research into optimal treatment strategies for pediatric CPP is warranted.
Background:
A review of the choroid plexus papilloma of the lateral ventricle in the pediatric age group is presented. The characteristic clinical features, imaging studies, preoperative, and operative approaches, as well as complications, will be included.
Methods:
Among a group of 24 patients with ventricular choroid plexus papilloma treated by the authors over a 12-year period, seven patients were selected for this study. The selection included patients under the age of 8 years at the time of their presentation with choroid plexus papilloma of the lateral ventricle. Adult patients and children with choroid plexus papilloma at other sites or choroid plexus carcinoma were excluded. At least a 30-month follow-up period was available for all patients except one. Preoperative and postoperative imaging studies confirming total tumor resection were available for all patients.
Results:
Developmental delays and regression were the most consistent clinical features. Magnetic resonance imaging (MRI) proved to be the diagnostic test of choice. The addition of magnetic resonance angiogram (MRA) obviates the need for angiography. Our attempts at tumor embolization failed.
Conclusion:
An intersulcal splitting approach to the lateral ventricular trigone, combined with a perioperative external ventricular drainage, may be of value in the avoidance of symptomatic subdural effusions.
