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Childhood choroid plexus neoplasms. A study of 14 cases less than 2 years old
Insights
This study on choroid plexus papilloma (CPP) in children found that while computed tomography (CT) aids diagnosis, even with treatment, the prognosis for malignant CPP remains poor.
Area of Science:
- Pediatric Neurosurgery
- Neuroradiology
- Pediatric Oncology
Background:
- Choroid plexus papilloma (CPP) is a rare tumor affecting young children.
- Understanding the diagnostic challenges and prognostic factors is crucial for effective management.
Purpose of the Study:
- To analyze the clinical presentation, diagnostic methods, and outcomes of pediatric choroid plexus papilloma.
- To evaluate the efficacy of computed tomography (CT) in diagnosing CPP and differentiating between benign and malignant forms.
Main Methods:
- Retrospective review of 14 pediatric patients diagnosed with choroid plexus papilloma.
- Analysis of diagnostic imaging, including computed tomography (CT) and comparison with other modalities.
- Evaluation of treatment approaches and patient follow-up data.
Main Results:
- Most pediatric CPP cases occurred in the lateral ventricles.
- Computed tomography (CT) with contrast media proved effective for diagnosing CPP and distinguishing between benign and malignant subtypes.
- Pneumoencephalography was deemed too dangerous for diagnostic use.
- Despite surgical removal and shunting, patients with malignant CPP exhibited a poor prognosis.
Conclusions:
- Computed tomography (CT) is the preferred imaging modality for pediatric choroid plexus papilloma.
- Malignant choroid plexus papilloma carries a significant risk of poor outcomes in children.
- Early and accurate diagnosis is essential, but therapeutic challenges remain for aggressive forms of CPP.
Abstract:
Fourteen children less than 2 years old with choroid plexus papilloma (CPP) were studied. Of these patients nine had the tumor in the lateral ventricles (LV), three in the fourth ventricle (4th V), one in the third ventricle (3rd V) and one in the third and left lateral ventricle (LLV). Ten cases showed benign CPP, three cases malignant CPP, and one case had a venous malformation of the choroid plexus (VMCP). Computed tomography (CT) was the best method for neuroradiological study, although a very small CPP in the 3rd V was not detected in an early study. Malignant and benign CPP can be differentiated with CT, especially if the study is performed with contrast media. Pneumoencephalography must be rejected because it is very dangerous and may be the cause of death in some cases. The follow-up of patients with CPP showed a poor prognosis, even after correctly removing the tumor and inserting a shunt.