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NAGAI A, KANAMORI M, SHIMODA Y, WATANABE M, SAITO R, KUMABE T, AIZAWA T, TOMINAGA T. Delayed Recurrence of Choroid Plexus Carcinoma in the Sacral Spinal Cord 17 Years after Its Initial Presentation. NMC Case Rep J 2022; 9:301-306. [PMID: 36263187 PMCID: PMC9534564 DOI: 10.2176/jns-nmc.2022-0056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2022] [Accepted: 06/24/2022] [Indexed: 11/20/2022] Open
Affiliation(s)
- Arata NAGAI
- Department of Neurosurgery, Tohoku University Graduate School of Medicine
| | - Masayuki KANAMORI
- Department of Neurosurgery, Tohoku University Graduate School of Medicine
| | - Yoshiteru SHIMODA
- Department of Neurosurgery, Tohoku University Graduate School of Medicine
| | | | - Ryuta SAITO
- Department of Neurosurgery, Tohoku University Graduate School of Medicine
| | - Toshihiro KUMABE
- Department of Neurosurgery, Tohoku University Graduate School of Medicine
| | - Toshimi AIZAWA
- Department of Orhopaedic Surgery, Tohoku University Graduate School of Medicine
| | - Teiji TOMINAGA
- Department of Neurosurgery, Tohoku University Graduate School of Medicine
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Hosmann A, Hinker F, Dorfer C, Slavc I, Haberler C, Dieckmann K, Knosp E, Czech T. Management of choroid plexus tumors-an institutional experience. Acta Neurochir (Wien) 2019; 161:745-754. [PMID: 30783805 PMCID: PMC6431303 DOI: 10.1007/s00701-019-03832-5] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2018] [Accepted: 01/31/2019] [Indexed: 12/13/2022]
Abstract
Background Choroid plexus tumors are rare entities. Resection is the mainstay of treatment in grade I and grade II tumors and adjuvant treatment is usually reserved for the less frequent choroid plexus carcinoma (CPC). Outcome is not only related to their histological grade but also dependent on their size, location, and presence of often multifactorial disturbances of cerebrospinal fluid (CSF) circulation. Methods Retrospective analysis of 36 consecutive patients operated on a choroid plexus tumor at our institution in a mixed pediatric and adult population between 1991 and 2016. Results Twenty-one CPP, 11 atypical choroid plexus papillomas (aCPP), and four CPC were encountered in 17 children and 19 adults. Regardless of histological grading, gross-total resection (GTR) could be achieved in 91.7% of patients. Tumor recurrence (25.0%) was significantly associated with histological grading (p = 0.004), subtotal resection (p = 0.002), and intraoperatively evident zones of tumor infiltration (p = 0.001). Adjuvant therapy was performed in 19.4% of patients, mainly diagnosed with CPC. The 5-year overall survival rate was 95.2% for CPP and 100.0% for both aCPP and CPC. Survival was related to the extent of resection (p = 0.001), tumor progression (p = 0.04), and the presence of leptomeningeal metastases (p = 0.002). Even after resection, either ventricular or subdural shunting was required in 25.0% of patients. Conclusions We could confirm that GTR is crucial for treatment of choroid plexus tumors. Parenchymal tumor infiltration as detected intraoperatively was associated with the extent of resection and not limited to CPC. CSF disturbances mandating treatment may persist after resection.
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Affiliation(s)
- Arthur Hosmann
- Department of Neurosurgery, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria
- Comprehensive Cancer Center-Central Nervous System Tumors Unit (CCC-CNS), Medical University of Vienna, Vienna, Austria
| | - Felix Hinker
- Department of Neurosurgery, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria
| | - Christian Dorfer
- Department of Neurosurgery, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria
- Comprehensive Cancer Center-Central Nervous System Tumors Unit (CCC-CNS), Medical University of Vienna, Vienna, Austria
| | - Irene Slavc
- Comprehensive Cancer Center-Central Nervous System Tumors Unit (CCC-CNS), Medical University of Vienna, Vienna, Austria
- Department of Pediatrics and Adolescence Medicine, Medical University of Vienna, Vienna, Austria
| | - Christine Haberler
- Comprehensive Cancer Center-Central Nervous System Tumors Unit (CCC-CNS), Medical University of Vienna, Vienna, Austria
- Institute of Neurology, Medical University of Vienna, Vienna, Austria
| | - Karin Dieckmann
- Comprehensive Cancer Center-Central Nervous System Tumors Unit (CCC-CNS), Medical University of Vienna, Vienna, Austria
- Department of Radiotherapy, Medical University of Vienna, Vienna, Austria
| | - Engelbert Knosp
- Department of Neurosurgery, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria
- Comprehensive Cancer Center-Central Nervous System Tumors Unit (CCC-CNS), Medical University of Vienna, Vienna, Austria
| | - Thomas Czech
- Department of Neurosurgery, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria.
- Comprehensive Cancer Center-Central Nervous System Tumors Unit (CCC-CNS), Medical University of Vienna, Vienna, Austria.
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Morshed RA, Lau D, Sun PP, Ostling LR. Spinal drop metastasis from a benign fourth ventricular choroid plexus papilloma in a pediatric patient: case report. J Neurosurg Pediatr 2017; 20:471-479. [PMID: 28841111 DOI: 10.3171/2017.5.peds17130] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Choroid plexus papillomas (CPPs) are typically benign tumors that can occur in any age group but are more commonly found in pediatric patients. Although these tumors are benign, there are several reports in adult patients of distant metastases present either at the time of diagnosis or occurring months to years after initial resection. Here, the authors report the case of a 14-year-old boy who presented with symptoms of elevated intracranial pressure due to obstructive hydrocephalus that was caused by a large fourth ventricular mass. Preoperative imaging included a full MRI of the spine, which revealed an intradural lesion that encased the distal sacral nerve roots at the tip of the thecal sac and was concerning for a drop metastasis. The patient underwent gross-total resection of both the fourth ventricular and sacral tumors with histology of both lesions consistent with benign CPP (WHO Grade I). In addition, the authors review prior reports of both pediatric and adult patients in whom benign CPPs have metastasized with either benign or atypical pathology found at a distant site. Taking into account this unusual case and reports in the literature, patients with even benign CPPs may warrant initial and routine follow-up imaging of the total neural axis in search of the rare, but possible, occurrence of drop metastasis.
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Affiliation(s)
- Ramin A Morshed
- Department of Neurological Surgery, University of California, San Francisco; and
| | - Darryl Lau
- Department of Neurological Surgery, University of California, San Francisco; and
| | - Peter P Sun
- UCSF Benioff Children's Hospital Oakland, California
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Abdulkader MM, Mansour NH, Van Gompel JJ, Bosh GA, Dropcho EJ, Bonnin JM, Cohen-Gadol AA. Disseminated choroid plexus papillomas in adults: A case series and review of the literature. J Clin Neurosci 2016; 32:148-54. [PMID: 27372242 DOI: 10.1016/j.jocn.2016.04.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2016] [Accepted: 04/07/2016] [Indexed: 10/21/2022]
Abstract
Choroid plexus papillomas (CPPs) are uncommon, usually intraventricular, low-grade tumors, accounting for less than 1% of all intracranial neoplasms and 2-4% of brain tumors in children. Dissemination of CPPs to multiple levels of the neuraxis has been seldom observed. Thus far, only 26 adult patients have been reported in the English language literature. With some exceptions, disseminated CPPs have been observed in adults and involved multiple sites along the cerebrospinal fluid pathways. Occasionally, intraparenchymal extension has been documented, and secondary involvement of the suprasellar region has been reported in only five patients. Postoperative treatment of CPPs has not been standardized. Most recommended therapies have been extrapolated from a series of atypical papillomas or carcinomas of the choroid plexus in children. We herein report a series of three patients of disseminated choroid plexus papillomas providing additional insights into this relatively rare entity.
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Affiliation(s)
- Marwah M Abdulkader
- Department of Pathology and Laboratory Medicine, Indiana University School of Medicine, Indianapolis, IN 46202, USA
| | - Nassir H Mansour
- Department of Neurological Surgery, Indiana University School of Medicine, 340 W 10(th) Street #6200, Indianapolis, IN 46202, USA
| | - Jamie J Van Gompel
- Departments of Neurosurgery and Otolaryngology, Mayo Clinic, Rochester, MN 55905, USA
| | - Gregory A Bosh
- Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Indianapolis, IN 46202, USA
| | - Edward J Dropcho
- Department of Neurology, Indiana University School of Medicine, Indianapolis, IN 46202, USA
| | - Jose M Bonnin
- Department of Pathology and Laboratory Medicine, Indiana University School of Medicine, Indianapolis, IN 46202, USA
| | - Aaron A Cohen-Gadol
- Department of Neurological Surgery, Indiana University School of Medicine, 340 W 10(th) Street #6200, Indianapolis, IN 46202, USA.
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Safaee M, Oh MC, Bloch O, Sun MZ, Kaur G, Auguste KI, Tihan T, Parsa AT. Choroid plexus papillomas: advances in molecular biology and understanding of tumorigenesis. Neuro Oncol 2012; 15:255-67. [PMID: 23172371 DOI: 10.1093/neuonc/nos289] [Citation(s) in RCA: 62] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Choroid plexus papillomas are rare, benign tumors originating from the choroid plexus. Although generally found within the ventricular system, they can arise ectopically in the brain parenchyma or disseminate throughout the neuraxis. We sought to review recent advances in our understanding of the molecular biology and oncogenic pathways associated with this disease. A comprehensive PubMed literature review was conducted to identify manuscripts discussing the clinical, molecular, and genetic features of choroid plexus papillomas. Articles concerning diagnosis, treatment, and long-term patient outcomes were also reviewed. The introduction of atypical choroid plexus papilloma as a distinct entity has increased the need for accurate histopathologic diagnosis. Advances in immunohistochemical staining have improved our ability to differentiate choroid plexus papillomas from other intracranial tumors or metastatic lesions using combinations of key markers and mitotic indices. Recent findings have implicated Notch3 signaling, the transcription factor TWIST1, platelet-derived growth factor receptor, and the tumor necrosis factor-related apoptosis-inducing ligand pathway in choroid plexus papilloma tumorigenesis. A combination of commonly occurring chromosomal duplications and deletions has also been identified. Surgical resection remains the standard of care, although chemotherapy and radiotherapy may be considered for recurrent or metastatic lesions. While generally considered benign, these tumors possess a complex biology that sheds insight into other choroid plexus tumors, particularly malignant choroid plexus carcinomas. Improving our understanding of the molecular biology, genetics, and oncogenic pathways associated with this tumor will allow for the development of targeted therapies and improved outcomes for patients with this disease.
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Affiliation(s)
- Michael Safaee
- Department of Neurological Surgery, University of California at San Francisco, 505 Parnassus Ave., San Francisco, CA 94117, USA
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Tuchman A, Kalhorn SP, Mikolaenko I, Wisoff JH. Cystic choroid plexus papilloma in the cavum septum pellucidum. J Neurosurg Pediatr 2009; 4:580-3. [PMID: 19951048 DOI: 10.3171/2009.7.peds08484] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
A choroid plexus papilloma is a rare CNS neoplasm arising from the neuroepithelial lining of the choroid plexus. A third ventricular location of a choroid plexus papilloma is rare compared with the more common sites in the lateral and fourth ventricles. Cystic choroid plexus papilloma represents an infrequent subtype that may present diagnostic ambiguity. The authors present a case of cystic choroid plexus papilloma within a cavum septum pellucidum that radiographically mimicked neurocysticercosis.
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Affiliation(s)
- Alexander Tuchman
- Department of Neurosurgery, New York University Langone Medical Center, New York, New York, USA
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Wrede B, Hasselblatt M, Peters O, Thall PF, Kutluk T, Moghrabi A, Mahajan A, Rutkowski S, Diez B, Wang X, Pietsch T, Kortmann RD, Paulus W, Jeibmann A, Wolff JEA. Atypical choroid plexus papilloma: clinical experience in the CPT-SIOP-2000 study. J Neurooncol 2009; 95:383-392. [PMID: 19543851 PMCID: PMC5637399 DOI: 10.1007/s11060-009-9936-y] [Citation(s) in RCA: 104] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2009] [Accepted: 06/01/2009] [Indexed: 02/03/2023]
Abstract
Atypical choroid plexus papilloma (APP) represents a novel intermediate-grade subtype of choroid plexus tumor (CPT), the clinical outcome of which has not been described yet. We present the first analysis of a group of APP patients enrolled in the ongoing CPT-SIOP-2000 study of CPTs. A worldwide registration and a randomized trial for those patients who require chemotherapy started in 2000. For APP, maximal surgical resection was recommended. After surgery, patients who had undergone complete resection were observed, whereas patients with incompletely resected or metastasized APP were treated with six chemotherapy courses (etoposide and vincristine, combined with either carboplatin or cyclophosphamide). Risk-adapted radiotherapy was given only to patients older than 3 years of age. Of the 106 patients with a centrally confirmed CPT histology, 30 had APP, 42 CPP and 34 CPC. APP patients were significantly younger (median = 0.7 years) than patients with CPP or CPC (both medians = 2.3 years). Complete resection was achieved in 68 (64%) patients (79% in CPP, 63% in APP, and 47% in CPC). Metastases were present at diagnosis in 17% of APP patients, 5% of CPP patients, and 21% of CPC patients. All nine APP patients who received postoperative chemotherapy showed an early response after two cycles: two had complete remission, four had partial response, and three had stable disease. In the observation group of 15 patients, one event was seen, and all patients were alive. In the treatment group, one patient with a metastasized tumor and incompletely resected APP died. While APP was defined histologically, median percentages of both the Ki-67/MIB-1 proliferation marker and the p53 tumor suppressor protein increased across the three histological subtypes (from CPP to APP and then CPC), suggesting that the subtypes comprise an ordinal categorization of increasingly severe CPT tumors. This ordering was reiterated by clinical outcome in the 92 patients treated per the study protocol, with 5-year EFS rates of 92% in 39 CPP patients, 83% in 24 APP patients, and 28% in 29 CPC patients. A similar ordering was seen when all 106 patients were evaluated for EFS. APP responded favorably to chemotherapy. The intermediate position of APP between CPP and CPC was supported by the clinical data.
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Affiliation(s)
- Brigitte Wrede
- Department of Pediatric Oncology, St. Hedwig Children’s, Hospital, University of Regensburg, Regensburg, Germany
| | - Martin Hasselblatt
- Institute of Neuropathology, University Hospital Münster, Münster, Germany
| | - Ove Peters
- Department of Pediatric Oncology, St. Hedwig Children’s, Hospital, University of Regensburg, Regensburg, Germany
| | - Peter F. Thall
- Department of Biostatistics, The University of Texas M. D. Anderson Cancer Center, Houston, TX, USA
| | - Tezer Kutluk
- Institute of Oncology, Hacettepe University, Ankara, Turkey
| | - Albert Moghrabi
- Department of Pediatrics, Sainte-Justine Hospital, Montreal, Canada
| | - Anita Mahajan
- Department of Radiation Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, TX, USA
| | - Stefan Rutkowski
- Department of Pediatric Hematology and Oncology, University, of Hamburg-Eppendorf, Hamburg, Germany
| | - Blanca Diez
- Neuro Oncology Program, Institute of Neurological Research, FLENI, Buenos Aires, Argentina
| | - Xuemei Wang
- Department of Biostatistics, The University of Texas M. D. Anderson Cancer Center, Houston, TX, USA
| | - Torsten Pietsch
- Institute for Neuropathology, University of Bonn, Bonn, Germany
| | | | - Werner Paulus
- Institute of Neuropathology, University Hospital Münster, Münster, Germany
| | - Astrid Jeibmann
- Institute of Neuropathology, University Hospital Münster, Münster, Germany
| | - Johannes E. A. Wolff
- Department of Pediatric Oncology, St. Hedwig Children’s, Hospital, University of Regensburg, Regensburg, Germany,Department of Biostatistics, The University of Texas M. D. Anderson Cancer Center, Houston, TX, USA,Department of Pediatrics, Unit 87, The University of Texas M. D. Anderson Cancer Center, 1515 Holcombe Blvd., Houston, TX, 77030, USA
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Ahn SS, Cho YD. Spinal drop metastasis from a posterior fossa choroid plexus papilloma. J Korean Neurosurg Soc 2007; 42:475-7. [PMID: 19096592 DOI: 10.3340/jkns.2007.42.6.475] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2007] [Accepted: 11/12/2007] [Indexed: 11/27/2022] Open
Abstract
Choroid plexus papillomas (CPPs) are typically considered as benign tumors, with a favorable long-term prognosis. Drop metastasis of CPP into the spinal subarachnoid space is rare. We report a 42-year-old woman who presented with headache and back pain 6 years after removal of a posterior fossa CPP. Magnetic resonance imaging revealed mass lesions in the lumbosacral subarachnoid space and recurrent intracranial tumor. The lesions were resected and histologically diagnosed was CPP. We consider that CPP can spread via cerebrospinal fluid pathways and cause spinal drop metastasis. Therefore, it is necessary to evaluate the whole spinal axis and to perform periodic follow-up examinations in patients with CPP.
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Affiliation(s)
- Soon-Seob Ahn
- Department of Neurosurgery, Daegu Catholic University, School of Medicine, Daegu, Korea
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Ortega-Martínez M, Cabezudo-Artero JM, Fernández-Portales I, Pimentel JJ, Gómez de Tejada R. Diffuse leptomeningeal seeding from benign choroid plexus papilloma. Acta Neurochir (Wien) 2007; 149:1229-36; discussion 1236-7. [PMID: 17924056 DOI: 10.1007/s00701-007-1292-0] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2007] [Accepted: 06/12/2007] [Indexed: 11/30/2022]
Abstract
Choroid plexus papillomas (CPP) are rare intracranial tumours with a favourable long-term outcome after surgical excision. Although they are histologically benign, local recurrences may occasionally occur, but leptomeningeal dissemination is exceptional. We report an unusual example of a fourth ventricle choroid plexus papilloma with diffuse leptomeningeal seeding. Neither the initial tumour nor the recurrence showed malignant histological features. Treatment with systemic and intrathecal chemotherapy was ineffective in this patient. We review the literature concerning leptomeningeal dissemination of benign choroid plexus papillomas.
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Affiliation(s)
- M Ortega-Martínez
- Services of Neurosurgery, Hospital Regional Universitario Infanta Cristina, Avda de Elvas s/n, Badajoz, Spain.
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Kaptanoglu E, Tun K, Celikmez RC, Ozen O, Taskin Y. Spinal drop metastasis of choroid plexus papilloma. J Clin Neurosci 2007; 14:381-3. [PMID: 17240147 DOI: 10.1016/j.jocn.2005.12.017] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2005] [Revised: 12/07/2005] [Accepted: 12/09/2005] [Indexed: 10/23/2022]
Abstract
A rare case of choroid plexus papilloma (CPP) with spinal drop metastasis is presented. A 51-year-old woman was operated on for a tumor of the fourth ventricle with histopathological diagnosis of CPP. Seven years later, she was re-admitted with low back pain. MRI showed multilobulated tumor at the lumbosacral subarachnoidal space with histopathological diagnosis of CPP. Thus, CPP can spread via the cerebrospinal fluid pathways and cause drop metastasis.
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Affiliation(s)
- Erkan Kaptanoglu
- Ankara Numune Education and Research Hospital, Department of Neurosurgery, Ankara, 06550, Turkey.
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Uff CEG, Galloway M, Bradford R. Metastatic atypical choroid plexus papilloma: a case report. J Neurooncol 2006; 82:69-74. [PMID: 16955222 DOI: 10.1007/s11060-006-9238-6] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2006] [Accepted: 08/04/2006] [Indexed: 11/27/2022]
Abstract
Choroid plexus papillomas (CPPs) are rare adult tumours and metastatic disease is even less common, more typically associated with choroid plexus carcinoma. We present the case of a 32-year-old patient with multiple metastases arising along the length of the neuraxis 3 years after resection of an atypical fourth ventricular CPP. Metastatic deposits were found from the mid-brain to the lumbar cistern and the patient underwent repeat excision of the fourth ventricular tumour, partial resection of a cervico-thoracic deposit and craniospinal radiotherapy. Possible explanations for the rarity of atypical CPP include unclear diagnostic criteria leading to under-representation in reported cases. We review the current literature on metastatic CPP and discuss the role of surgery and adjuvant therapy in relation to both typical and atypical disease.
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McCall T, Binning M, Blumenthal DT, Jensen RL. Variations of disseminated choroid plexus papilloma: 2 case reports and a review of the literature. ACTA ACUST UNITED AC 2006; 66:62-7; discussion 67-8. [PMID: 16793445 DOI: 10.1016/j.surneu.2005.09.023] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2005] [Accepted: 09/11/2005] [Indexed: 11/29/2022]
Abstract
BACKGROUND Choroid plexus papillomas are typically considered benign lesions, but histology is not always predictive of their behavior. These tumors can metastasize anywhere along the neuraxis and may be intraventricular, subarachnoid, or intraparenchymal. We present 2 cases that illustrate the wide diversity with which choroid plexus papillomas can disseminate. CASE DESCRIPTIONS The patient described in case 1 had a primary fourth ventricular choroid plexus papilloma that produced diffuse cystic subarachnoid and leptomeningeal lesions. Patient 2 also had a primary fourth ventricular tumor but with subsequent suprasellar and spinal drop metastases. Patient 1 was treated with temozolomide, resulting in regression of symptoms including headache and dizziness. Patient 2 has been treated with several modalities, including radiation therapy and chemotherapy, with slowing of symptom progression. CONCLUSIONS Variations of choroid plexus papilloma dissemination include intraventricular, subarachnoid, and leptomeningeal nodules or cystic lesions, and intraparenchymal locations. There is no consensus on the most effective treatment for choroid plexus papilloma metastases; surgical resection, chemotherapy, and radiation therapy may all yield benefits. The prognosis for patients with disseminated choroid plexus papilloma can range from prolonged stable disease and symptoms to death within months.
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Affiliation(s)
- Todd McCall
- Department of Neurosurgery, University of Utah, Salt Lake City, UT 84132, USA
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Abstract
✓ The authors report an intrinsic brainstem lesion that was diagnosed initially as a pontine cavernoma, which finally proved to be a choroid plexus papilloma. Choroid plexus papillomas are rare tumors of the central nervous system and are usually intraventricular in location. The occurrence of this tumor in an intraparenchymal location is extremely rare, and its occurrence within the brainstem is previously unreported. The authors also report a trial of chemotherapy with lomustine in the management of the residual tumor.
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Affiliation(s)
- Ashok Pillai
- Department of Neurosurgery, Amrita Institute of Medical Sciences and Research Centre, Lisie Hospital, Kochi, Kerala, India
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