Related Experiment Video
Updated: Jun 6, 2026
Comprehensive Endovascular and Open Surgical Management of Cerebral Arteriovenous Malformations
Published on: October 20, 2017
Treatment of third ventricular choroid plexus papilloma in an infant with embolization alone
Joshua J Wind1, Randy S Bell, William O Bank
1Department of Neurological Surgery, The George Washington University, Washington, DC, USA.
Insights
Embolization led to the complete regression of a third ventricular choroid plexus papilloma in an infant. This minimally invasive approach offers a viable alternative to surgery for infant brain tumors.
Area of Science:
- Pediatric Neurosurgery
- Neuroradiology
- Pediatric Oncology
Background:
- Choroid plexus papillomas (CPPs) are rare tumors typically found in the fourth ventricle or lateral ventricles.
- Infantile third ventricular tumors present unique challenges due to anatomical location and patient age.
Observation:
- A 3-month-old boy presented with symptoms of increased intracranial pressure, including macrocephaly, vomiting, and irritability.
- Imaging revealed a third ventricular lesion consistent with choroid plexus papilloma, causing severe hydrocephalus.
Findings:
- Surgical resection was initially considered but deemed high-risk due to tumor vascularity and infant age.
- Vascular embolization was performed, unexpectedly resulting in complete tumor involution and regression.
- No residual or recurrent disease was observed during a 16-month follow-up period.
Implications:
- Embolization may be a safe and effective alternative to surgery for select infant choroid plexus papillomas.
- Close oncologic surveillance is crucial to monitor for any signs of residual or recurrent tumor after embolization.
- This case highlights a potential paradigm shift in managing pediatric third ventricular tumors.
Abstract:
The authors present the case of a 3-month-old boy with a third ventricular tumor consistent with a choroid plexus papilloma. This child presented with macrocephaly, irritability, inability to roll over, and vomiting. He was found to have an enlarged head circumference, a full and tense fontanel, splayed sutures, and forced downward gaze. Imaging revealed severe ventriculomegaly and a brightly enhancing third ventricular lesion consistent with papilloma. Treatment planning included placement of a ventriculoperitoneal shunt to treat hydrocephalus and to allow the child to grow prior to resection. Due to the vascular nature of these tumors and the age of this child, the tumor was embolized with a plan for eventual resection; however, embolization resulted in involution and total regression of the tumor. There is no residual disease at last follow-up of 16 months. In this specific scenario of a choroid plexus papilloma in an infant, when operative intervention may be technically difficult and associated with significant morbidity, embolization with close observation may be a valid treatment option. If used, the patient would need to be closely followed for evidence of residual or recurrent disease, which would require operative intervention.
