CSF Rhinorrhea: A Rare Clinical Presentation of Choroid Plexus Papilloma

Area of Science:

• Neuro-oncology
• Neurosurgery
• Radiation Oncology

Background:

• Choroid plexus papilloma (CPP) is a rare intracranial tumor predominantly affecting pediatric populations.
• Intraventricular location and increased intracranial pressure (ICP) are typical presentations of CPP.
• Cerebellopontine angle (CPA) location and cerebrospinal fluid (CSF) rhinorrhea are atypical manifestations.

Observation:

• A middle-aged female presented with spontaneous CSF rhinorrhea.
• The causative lesion was identified as a CPA tumor.
• Initial management involved craniotomy and subtotal tumor resection.

Findings:

• The patient remained progression and rhinorrhea-free for several years post-surgery.
• Recurrence or progression led to treatment with CyberKnife stereotactic radiosurgery.
• The patient exhibited clinical improvement and favorable radiologic response to radiosurgery.

Implications:

• This case expands the understanding of CPP presentation in adults.
• It underscores the efficacy of a multimodal treatment approach including radiosurgery for recurrent or residual CPA tumors.
• Highlights the potential for long-term disease control with advanced treatment modalities.