Choroid plexus tumors: problems in diagnosis and management

Choroid plexus tumors are uncommon neoplasms of the central nervous system. A series of 11 cases from the Vancouver General and British Columbia Children's Hospitals, treated during the last 12 years, are reviewed. Some of the management problems commonly encountered with these tumors are discussed. Many of these tumors are associated with severe hydrocephalus at the time of diagnosis, and the perioperative management of this hydrocephalus remains a matter of some debate. The timing of and the necessity for shunting are major considerations. Large subdural fluid collections are often discovered in the postoperative period, and these occasionally cause symptoms of increased intracranial pressure. Reasons for this problem are suggested and possible steps for its prevention are proposed. The similarity between papillary ependymomas and choroid plexus papillomas has sometimes caused difficulty in pathological diagnosis. Choroid plexus carcinomas, of which there were two in this series, also present a diagnostic challenge. Differential diagnosis affects the further treatment and prognosis for the patient.