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[Papilloma of the choroid plexus. Apropos of 11 cases]
H Yettou1, J C Marchal, L Vinikoff
1Unité de Neurochirurgie Pédiatrique, Hôpital Saint-Julien, CHU de Nancy.
Insights
Choroid plexus papillomas (CPP) in children require surgical removal. Transient external CSF shunting before surgery may prevent the need for permanent shunts, simplifying long-term management.
Area of Science:
- Pediatric Neurosurgery
- Pediatric Oncology
- Neuropathology
Context:
- Choroid plexus papillomas (CPP) are rare pediatric tumors.
- Hydrocephalus is a common complication of CPP.
- Surgical management of pediatric CPP presents unique challenges.
Purpose:
- To review surgical outcomes for 11 pediatric choroid plexus papillomas.
- To evaluate the role of CSF shunting in managing hydrocephalus associated with CPP.
- To discuss surgical strategies for hypervascular CPP in children.
Summary:
- Eleven pediatric cases of choroid plexus papillomas (CPP) treated between 1979-1993 are presented.
- Complete tumor resection was achieved in all cases, with hydrocephalus consistently present.
- Transient external CSF shunting prior to surgery was effective in avoiding permanent shunting in most cases.
Impact:
- Highlights the efficacy of transient external CSF shunting in managing hydrocephalus in pediatric CPP.
- Provides insights into surgical challenges and strategies for hypervascular pediatric brain tumors.
- Contributes to the understanding of long-term outcomes for children with choroid plexus papillomas.
Abstract:
The authors report 11 cases of choroid plexus papillomas in children operated on from 1979 until 1993. The age ranges from 2 months to 14 years old. The most frequent location occurred in the lateral ventricles (7 cases) followed by the locations in the third ventricle (3 cases) and the fourth ventricle (1 case). A complete resection was performed in all the cases. Hydrocephalus induced by the tumors was always present. An internal and permanent shunting procedure was carried out in the pre-operative period in 5 cases, in the post-operative course in 1 case. 3 cases underwent an external CSF shunting before surgery. This external CSF drainage has been taken out a few days after the surgical resection and no further permanent internal shunting was required in the long-term outcome. In 2 cases, no CSF drainage was performed either before or after surgery. Choroid plexus papillomas (CPP) require surgical management. The hypervascularisation of these tumors can give rise to important bleeding and generate surgical difficulties particularly in children under one year. The best way to remove these tumors would be to reach the arterial feeder(s) in first place, but it is not always possible. It's also difficult to forecast wether or nor the hydrocephalus will require further permanent CSF drainage, so we have chosen to carry on an external and transient CSF shunting.