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[Choroid plexus tumors in infancy]
A Asai1, H J Hoffman, M Matsutani
1Division of Neurosurgery, Hospital for Sick Children, University of Toronto, Canada.
Insights
Choroid plexus tumors in infants often present with rapid head enlargement and vomiting. Surgical removal and hydrocephalus management lead to favorable outcomes, with most survivors showing normal development.
Area of Science:
- Pediatric Neurosurgery
- Pediatric Oncology
- Pediatric Neurology
Background:
- Choroid plexus tumors are rare intracranial neoplasms in infants.
- Early diagnosis and management are crucial for favorable outcomes.
- Hydrocephalus is a common complication requiring intervention.
Observation:
- Retrospective review of 12 infants diagnosed with choroid plexus tumors.
- Common presenting symptoms included enlarging head circumference, bulging fontanelle, and vomiting.
- Average age at diagnosis was 7.7 months, with symptoms preceding diagnosis by a mean of 3.7 weeks.
Findings:
- 11 of 12 tumors were choroid plexus papillomas; 1 was a choroid plexus carcinoma.
- Complete tumor removal was achieved in 11 patients.
- Cerebrospinal fluid (CSF) diversionary shunts were necessary in 10 infants.
- Eleven of 12 patients survived with normal psychomotor and neurological development after a mean follow-up of 5.6 years.
Implications:
- Surgical resection of choroid plexus tumors in infants can lead to excellent long-term outcomes.
- Effective management of associated hydrocephalus is critical for patient survival and development.
- Prompt diagnosis and intervention are essential for improving prognosis in pediatric choroid plexus tumors.
Abstract:
Twelve infants with choroid plexus tumors were reviewed retrospectively. Enlarging head circumference, bulging fontanelle, and vomiting were the major symptoms and signs appearing 2 to 5 weeks (mean = 3.7 weeks) before diagnosis. The average age at diagnosis was 7.7 months. Total removal was performed in 11 patients with choroid plexus papilloma, and partial removal was achieved in 1 patient with a choroid plexus carcinoma. A cerebrospinal fluid (CSF) diversionary shunt was placed temporarily in 6 infants and permanently in 4. Of the two patients not requiring CSF diversionary shunt, 1 needed a subdural-peritoneal shunt postoperatively. Histologically, 11 of 12 tumors were choroid plexus papillomas, and one was a choroid plexus carcinoma. All 12 patients were followed up for 4 months to 11 years (mean = 5.6 years). Eleven of 12 patients were alive at the time of their last check-up. All 11 survivors had normal psychomotor and neurological development. The treatment and outcome of choroid plexus tumors and management of associated hydrocephalus are discussed.