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Choroid plexus papillomas
1Department of Neurosurgery, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, India.
Insights
Choroid plexus papillomas (CPPs) are rare brain tumors. Complete surgical removal offers the best outcome for patients with these rare neoplasms.
Area of Science:
- Neurosurgery
- Oncology
- Neuropathology
Background:
- Choroid plexus papillomas (CPPs) are rare intracranial neoplasms, comprising less than 1% of all brain tumors.
- These tumors most commonly occur in the fourth ventricle in adults, but posterior fossa locations were noted more frequently in children in this series.
Purpose of the Study:
- To present the clinical experience with 13 consecutive cases of choroid plexus papillomas.
- To analyze the management, outcomes, and optimal surgical approach for CPPs.
Main Methods:
- Retrospective review of 13 patients (8 children, 5 adults) managed between 1981 and 1991.
- All patients underwent surgical tumor resection, with histological confirmation.
- Tumor location, extent of resection, and patient outcomes were analyzed.
Main Results:
- Tumors were located in the fourth ventricle (5), lateral ventricle (4), third ventricle (1), cerebellomedullary cistern (2), and cerebellopontine angle (1).
- Total tumor excision was achieved in 9 patients, with subtotal excision in 4.
- Two surgical mortalities occurred early in the series. Nine patients are doing well with follow-up ranging from 9 to 90 months.
Conclusions:
- Surgical resection aiming for total excision should be the primary treatment strategy for choroid plexus papillomas.
- While the fourth ventricle is a common site, posterior fossa locations can occur, even in pediatric patients.
Abstract:
Choroid plexus papillomas (CPPs) are rare neoplasms accounting for less than 1% of all intracranial tumours. We present our experience with 13 consecutive cases managed by us between 1981 and 1991. There were eight children and five adults. Five patients had tumours in the 4th ventricle, four in lateral ventricle, one in the 3rd ventricle, two in the cerebellomedullary cistern and one in the cerebellopontine angle. The cerebellomedullary cistern is a rare site for CPPs. Although the 4th ventricle remains the common site for adult CPPs, in our series there was a higher incidence of posterior fossa papillomas even in children. Only six patients out of 13 underwent precraniotomy shunts. All patients had their tumours operated upon and verified histologically. Total excision of the tumour could be achieved in nine patients; only a sub total excision was possible in the remaining four. There were two surgical mortalities in the earlier part of this series. Two patients with subtotal excisions underwent radiation therapy; one of these had regrowth of the tumour and another was lost to follow up. The other nine patients are doing well with a follow-up ranging from 9 to 90 months. Surgical resection with the objective of achieving total excision should be attempted in these tumours.