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Choroid plexus papilloma of bilateral lateral ventricle
T Erman1, A I Göçer, S Erdoğan
1Department of Neurosurgery, Cukurova University, School of Medicine, Adana, Turkey.
Insights
Bilateral choroid plexus papilloma is an extremely rare brain tumor in children. Complete surgical removal of these tumors can cure the condition and resolve associated hydrocephalus.
Area of Science:
- Pediatric Neurosurgery
- Neuro-oncology
- Ventricle Tumors
Background:
- Choroid plexus papillomas (CPPs) are rare intracranial tumors, more prevalent in children than adults.
- CPPs typically occur in the lateral ventricles, with bilateral involvement being exceptionally uncommon.
Observation:
- A 3-year-old boy presented with irritability and vomiting, exhibiting normal neurological examination.
- Imaging revealed bilateral lateral ventricle tumors, hydrocephalus, and a temporal arachnoid cyst, with a presumptive diagnosis of CPPs.
Findings:
- Histological examination confirmed bilateral choroid plexus papilloma after surgical resection.
- Total tumor resection successfully controlled hydrocephalus and treated the neoplasm.
Implications:
- Bilateral CPP requires distinct surgical approaches compared to diffuse villous hypertrophy.
- Preoperative MRI is crucial for differential diagnosis; total surgical resection is the recommended treatment for bilateral CPP.
Background:
Choroid plexus papillomas are rare, accounting for less than 1% of all intracranial tumours in adults. However, they are relatively more common in childhood and constitute 1.5 to 4% of intracranial tumours. They are most often located in the lateral ventricle, followed by the fourth and third ventricles and, rarely, in the cerebellopontine angle. Bilateral lateral ventricle choroid plexus papilloma is very rare and only a few cases has been reported.
Clinical Presentation:
A 3-year-old boy was admitted to our hospital with a history of irritability and vomiting. Neurological examination on admission was normal. A head computed tomographic scan and magnetic resonance imaging showed tumours in both lateral ventricles, hydrocephalus and a left temporal arachnoid cyst. The bilateral intraventricular mass enhanced densely and homogeneously. A presumptive diagnosis of choroid plexus papillomas was made.
Interpretation:
The initial surgery was performed for removal of the lesion in the right lateral ventricle, and 20 days later removal of the left lateral ventricle tumour was carried out. Bilateral temporoparietal craniotomy and total removal of tumours was performed. Hydrocephalus was controlled by total tumour resection from both sides. The histology of these tumours was the same and revealed choroid plexus papilloma. Interpretation: Bilateral choroid plexus papilloma is extremely rare and distinct from diffuse villous hypertrophy and their surgical approaches are different from each other. Differential diagnosis should be made by MRI preoperatively. If bilateral choroid plexus papilloma is detected, total surgical resection should be performed. Total surgical removal of the neoplasm not only cures the tumour but also may lead to complete resolution of the hydrocephalus.