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Choroid plexus papillomas of the fourth ventricle. Report of 3 cases
Insights
Benign choroid plexus papillomas (CPP) in young infants can cause hydrocephalus. Early diagnosis is crucial as pneumoencephalography may not reveal these fourth ventricle tumors, impacting treatment outcomes.
Area of Science:
- Pediatric Neurosurgery
- Neuroradiology
- Pediatric Oncology
Background:
- Choroid plexus papillomas (CPP) are rare tumors, often presenting in the pediatric population.
- Fourth ventricle tumors can lead to obstructive hydrocephalus, particularly in neonates.
- The diagnostic challenges of intracranial tumors in infants necessitate careful evaluation.
Observation:
- This study details 3 cases of benign choroid plexus papillomas located in the fourth ventricle of patients under 2 months of age.
- These cases were part of a larger series of 100 posterior fossa tumors, with 14 identified as intracranial CPP.
- Pneumoencephalography failed to provide a correct diagnosis in these instances, showing seemingly normal fourth ventricle filling.
Findings:
- All 3 infants presented with hydrocephalus, with one case diagnosed prenatally ('intra utero').
- Two patients succumbed to complications following ventriculoperitoneal shunt placement and prior to tumor extirpation.
- Benign CPP in the fourth ventricle poses a significant risk of rapid hydrocephalus development in neonates.
Implications:
- The findings highlight the limitations of pneumoencephalography in diagnosing fourth ventricle CPP in neonates.
- Urgent and accurate diagnostic modalities are essential for timely intervention in infants with suspected intracranial tumors.
- Improved diagnostic strategies and prompt surgical management are critical to improve outcomes for infants with pediatric brain tumors.
Abstract:
3 cases with benign choroid plexus papillomas (CPP) in the fourth ventricle are described. All patients were less than 2 months of age. They were among 14 cases with intracranial CPP in a series of 100 tumors of the posterior fossa. Correct diagnosis was not obtained by means of pneumoencephalography, with apparently normal repletion of the fourth ventricle being visualized. 2 of the 3 patients died after application of the ventriculoperitoneal shunt and before extirpation of the tumor. All 3 patients soon presented hydrocephalus in 1 case already 'intra utero'.