Usefulness of synaptophysin immunohistochemistry in an adult case of choroid plexus carcinoma

Primary adult choroid plexus carcinomas: a single-center experience with a systematic review

Objective

Primary adult choroid plexus carcinomas (PACPCs) are extremely rare brain tumors. The existing literature primarily comprises case reports, which limits our understanding of this uncommon disease. This study aims to describe the clinical characteristics and prognosis of PACPCs, as well as to identify optimal treatment strategies.

Methods

We conducted a comprehensive analysis of clinical data from 7 patients with PACPCs who underwent surgical treatment at the Department of Neurosurgery, Beijing Tiantan Hospital, between March 2011 and March 2023. Additionally, a thorough search of the PubMed database was performed using the keywords "choroid plexus carcinoma" or "choroid plexus carcinomas" within the time frame of August 1975 to April 2023, which yielded a total of 28 identified cases. Subsequently, we evaluated risk factors for progression-free survival (PFS) and overall survival (OS) based on the pooled cases.

Results

The pooled cohort, consisting of 7 cases from our institution and 28 cases from the literature, included 20 males and 15 females with a mean age of 44.3 ± 14.7 years (range: 21-73 years). Gross-total resection (GTR) and non-GTR were achieved in 22 (62.9%) and 13 (37.1%) patients, respectively. Radiotherapy and chemotherapy were administered to 29 (90.6%) and 13 (40.6%) patients, respectively. After a mean follow-up of 21.0 ± 26.7 months (range: 2-132 months), 18 patients were alive, and 11 patients had died. The multivariate Cox regression model demonstrated that non-GTR (HR 5.262, 95% CI 1.350-20.516, p=0.017) was a negative prognostic factor for OS. However, we did not find any risk factors for PFS.

Conclusion

Complete surgical resection should be considered as the primary treatment approach for this rare disease. Chemotherapy and radiotherapy appear to have limited effectiveness in treating this condition. Further research with large cohorts is needed to validate our conclusions.

NordiQC Assessments of Synaptophysin Immunoassays

This paper is number 8 in a series developed through a partnership between ISIMM and NordiQC with the purpose of reporting research assessing the performance characteristics of immunoassays in an external proficiency testing program.

SUPRATENTORIAL, EXTRAVENTRICULAR CHOROID PLEXUS CARCINOMA IN AN ADULT

OBJECTIVE

Choroid plexus carcinoma (CPCa) is an uncommon tumor rarely occurring in patients older than 2 years of age. The case reported herein represents the first documented example of a primary supratentorial, extraventricular CPCa in an adult. The scant literature regarding this topic is reviewed.

CLINICAL PRESENTATION

A 68-year-old woman presented with transient expressive aphasia. Magnetic resonance imaging demonstrated an avidly enhancing, left temporal, extra-axial mass with associated parenchymal cysts.

INTERVENTION

The tumor was gross-totally removed via a frontotemporal craniotomy. A diagnosis of CPCa was made on histological, immunohistochemical, and ultrastructural grounds. Postoperatively, the patient was treated by local radiotherapy and temozolomide. A magnetic resonance imaging scan 44 months after surgery showed no evidence of residual or recurrent tumor.

CONCLUSION

CPCa infrequently affects adults. Only rarely does it present as a supratentorial, extraventricular mass. Resection is the mainstay of therapy. Adjuvant radiation and chemotherapy are rational treatment options.

Choroid plexus carcinoma secreting carbohydrate antigen 19-9 in an adult. Case report

A 53-year-old man presented with a choroid plexus carcinoma in the body of the right lateral ventricle manifesting as gait disturbance due to left mild hemiparesis and papilledema. Subtotal removal of the tumor was performed. Histological examination revealed well-differentiated papillary adenocarcinoma. Immunohistochemical examination showed intense reactivity for carbohydrate antigen 19-9 (CA19-9). The serum level of CA19-9 was significantly high, but decreased rapidly after radiation therapy. Systemic examinations found no malignancy in other organs. This second case of choroid plexus carcinoma producing CA19-9 indicates that CA19-9 may be a useful marker of choroid plexus carcinoma.