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Giant Choroid Plexus Papilloma Resection Utilizing a Transcollation System
Karam Asmaro1,2, Jacob Pawloski1, Jesse Skoch2
1Department of Neurosurgery, Henry Ford Health System, Detroit, Michigan.
Insights
A transcollation system effectively managed bleeding during pediatric brain tumor surgery, achieving total resection with minimal blood loss and preserving healthy tissue. This innovative approach offers a safe hemostatic option for complex neurosurgical cases.
Area of Science:
- Neurosurgery
- Pediatric Oncology
- Vascular Surgery
Background:
- Large, vascular brain tumors like choroid plexus papilloma (CPP) present significant surgical challenges in young children.
- Intraoperative hemostasis and minimizing blood loss are critical concerns during resection of these highly vascular tumors.
- Total resection offers a cure but carries substantial surgical risks, particularly concerning hemorrhage control.
Observation:
- A 3-year-old girl with a giant choroid plexus papilloma (CPP) in the right lateral ventricle required surgical intervention.
- The tumor's significant vascularity and the patient's limited intravascular reserve necessitated advanced hemostatic techniques.
- A transcollation system was employed during surgery to mitigate intraoperative blood loss.
Findings:
- Gross total resection of the CPP was successfully achieved.
- Intraoperative blood loss was approximately 300 mL, with no reported complications.
- Postoperative recovery was uneventful, and follow-up imaging at 3 months showed restored normal brain architecture.
Implications:
- Transcollation devices represent a valuable and safe addition to neurosurgical hemostatic tools.
- This technology can be particularly beneficial in high-risk intracranial tumor resections where hemorrhage is a major concern.
- The successful application in this pediatric case suggests broader utility in managing vascular neurosurgical challenges.
Background:
Large vascular brain tumors pose an exceptional challenge in young children. Choroid plexus papilloma (CPP) is an example of a rare, often large and especially vascular neuroepithelial tumor that most commonly arises in children under 5 yr old. Although patients may be cured by total resection, this tumor poses significant surgical risks and challenges related to intraoperative hemostasis.
Objective:
To describe our experience using a transcollation system during brain tumor surgery in a child to achieve hemostasis and minimize blood loss while preserving normal brain tissue.
Methods:
A 3-yr-old girl presented following a fall and was found to have a giant CPP growing from the right lateral ventricle. Given the vascularity of the tumor and the low intravascular reserve in a small child, a transcollation device was used to reduce blood loss intraoperatively.
Results:
Gross total resection was achieved with approximately 300 mL of blood loss without complications. The patient did well postoperatively. Imaging performed at 3 mo after resection revealed return of normal brain architecture.
Conclusion:
Transcollation devices appear to be an effective and safe addition to the armamentarium of neurosurgical hemostatic options in intracranial tumor resection in which there is a high risk of intraoperative hemorrhage.
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