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Zuo P, Mai Y, Jiang Z, Zhang B, Wang Y, Zhang M, Wu Z, Zhang J, Zhang L. Primary adult choroid plexus carcinomas: a single-center experience with a systematic review. Front Oncol 2023; 13:1260116. [PMID: 38023259 PMCID: PMC10651083 DOI: 10.3389/fonc.2023.1260116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Accepted: 10/20/2023] [Indexed: 12/01/2023] Open
Abstract
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.
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Affiliation(s)
- Pengcheng Zuo
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Yiying Mai
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Zhuang Jiang
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Bochao Zhang
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Yujin Wang
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Mingxin Zhang
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Zhen Wu
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Junting Zhang
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Liwei Zhang
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- China National Clinical Research Center for Neurological Diseases, Beijing, China
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Jo IY, Yeo SG, Oh HJ, Oh JS. Choroid plexus carcinoma with leptomeningeal spread in an adult: a case report and review of the literature. J Med Case Rep 2021; 15:286. [PMID: 34022951 PMCID: PMC8141193 DOI: 10.1186/s13256-021-02887-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Accepted: 05/02/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Choroid plexus carcinoma is an intraventricular neoplasm originating from the choroid plexus epithelium and is of rare occurrence in adults. However, owing to the low prevalence of choroid plexus carcinoma, there is very limited information about the disease entity and treatment. Here we report a rare case of choroid plexus carcinoma in an adult patient. CASE PRESENTATION A 46-year-old South Korean (East Asian) male presented with low back pain, headache, and diplopia. Magnetic resonance imaging demonstrated enhancing mass lesion in the left trigone, cerebellar with leptomeningeal spread. Surgery was performed via left parietal craniotomy, and the lesion was histologically confirmed to be choroid plexus carcinoma. The patient received adjuvant craniospinal irradiation for remnant mass and leptomeningeal spread. Magnetic resonance imaging performed immediately after completion of the treatment revealed a partial decrease in the size of the tumor. However, the patient expired died as a result of acute respiratory distress syndrome before follow-up of long-term outcome. CONCLUSION Choroid plexus carcinoma with leptomeningeal spread in adults is very important for rapid diagnosis and treatment. In the case of the presence of leptomeningeal spread, craniospinal irradiation can be considered as a treatment method, but may have serious complications. Hence, the technique should be applied with care.
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Affiliation(s)
- In Young Jo
- Department of Radiation Oncology, Soonchunhyang University College of Medicine, Cheonan, Republic of Korea
| | - Seung-Gu Yeo
- Department of Radiation Oncology, Soonchunhyang University College of Medicine, Cheonan, Republic of Korea
| | - Hyuk-Jin Oh
- Department of Neurosurgery, Soonchunhyang University College of Medicine, Cheonan, Republic of Korea.
| | - Jae-Sang Oh
- Department of Neurosurgery, Soonchunhyang University College of Medicine, Cheonan, Republic of Korea
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Witten AJ, Mendenhall SK, DeWitt LS, Vortmeyer A, Cohen-Gadol A. Cerebellopontine Angle Primary Choroid Plexus Carcinoma Present in an Adult: Case Report and Literature Review. Cureus 2021; 13:e13268. [PMID: 33717766 PMCID: PMC7954515 DOI: 10.7759/cureus.13268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Choroid plexus tumors (CPTs) are rare intraventricular neoplasms that primarily occur in children and are rare in adults. Of the CPT subtypes, choroid plexus carcinomas (CPC) are highly aggressive and malignant and of World Health Organization (WHO) Grade III. Dissemination through the cerebrospinal fluid space is the inevitable natural course of the disease. In this case report, we present a 33-year-old female with a past medical history notable for schizophrenia and bipolar disease who suffered from left-sided acute vision loss and hearing loss. Magnetic resonance imaging (MRI) demonstrated multiple enhancing masses found in the left cerebellopontine angle (CPA), right internal auditory canal, the atrium of the left ventricle, and the left foramen of Monroe. After surgical decompression of the CPA tumor, the permanent final pathology was consistent with CPC. To our knowledge, this is the first reported case of a primary CPC occurring within the CPA in an adult. The unique presentation and progression of this rare adult-onset CPC provide insight for the diagnosis and treatment of other rare instances of CPTs.
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Affiliation(s)
- Andrew J Witten
- Neurological Surgery, Indiana University School of Medicine, Indianapolis, USA
| | - Stephen K Mendenhall
- Department of Neurological Surgery, Indiana University Health, Indianapolis, USA
| | - Logan S DeWitt
- Department of Pathology and Laboratory Medicine, Indiana University Health, Indianapolis, USA
| | - Alexander Vortmeyer
- Department of Pathology and Laboratory Medicine, Indiana University Health, Indianapolis, USA
| | - Aaron Cohen-Gadol
- Department of Neurological Surgery, Indiana University Health, Indianapolis, USA
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Crea A, Bianco A, Cossandi C, Forgnone S, Fornaro R, Crobeddu E, Marino D, Piras G, Scalia G, Saglietti C, Boldorini R, Galzio R, Panzarasa G. Choroid Plexus Carcinoma in Adults: Literature Review and First Report of a Location into the Third Ventricle. World Neurosurg 2020; 133:302-307. [DOI: 10.1016/j.wneu.2019.10.051] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2019] [Revised: 10/06/2019] [Accepted: 10/08/2019] [Indexed: 11/17/2022]
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Effect of Surgery, Adjuvant Therapy, and Other Prognostic Factors on Choroid Plexus Carcinoma: A Systematic Review and Individual Patient Data Analysis. Int J Radiat Oncol Biol Phys 2017; 99:1199-1206. [DOI: 10.1016/j.ijrobp.2017.08.012] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2017] [Accepted: 08/10/2017] [Indexed: 12/15/2022]
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Smith AB, Smirniotopoulos JG, Horkanyne-Szakaly I. From the radiologic pathology archives: intraventricular neoplasms: radiologic-pathologic correlation. Radiographics 2013; 33:21-43. [PMID: 23322825 DOI: 10.1148/rg.331125192] [Citation(s) in RCA: 88] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
A variety of neoplasms may arise in the ventricular system. Intraventricular neoplasms may be discovered as an incidental finding at cross-sectional imaging or may manifest with varied symptoms depending on their location, including symptoms of increased intracranial pressure. These lesions may arise from various ventricular structures, including the ependymal lining (eg, ependymoma), subependymal layer (eg, subependymoma), or choroid plexus (eg, choroid plexus neoplasms), or they may have a cell of origin that has yet to be determined (eg, chordoid glioma). Other neoplasms involving the ventricular system include central neurocytoma, subependymal giant cell tumor, meningioma, rosette-forming glioneuronal tumor, and metastases. The differential diagnosis for intraventricular neoplasms can be broad, and many of them have similar patterns of signal intensity and contrast enhancement at imaging. However, the location of the lesion in the ventricular system-along with knowledge of the patient's age, gender, and underlying conditions-will help narrow the differential diagnosis.
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Affiliation(s)
- Alice Boyd Smith
- Department of Radiology and Radiological Sciences, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Rd, Bethesda, MD 20814-4799, USA.
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Mazloom A, Wolff JE, Paulino AC. The impact of radiotherapy fields in the treatment of patients with choroid plexus carcinoma. Int J Radiat Oncol Biol Phys 2009; 78:79-84. [PMID: 20004534 DOI: 10.1016/j.ijrobp.2009.07.1701] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2009] [Revised: 07/16/2009] [Accepted: 07/16/2009] [Indexed: 11/29/2022]
Abstract
PURPOSE To perform a comprehensive literature review and analysis of cases dealing with choroid plexus carcinoma (CPC) to determine the optimal radiotherapy (RT) treatment field. METHODS AND MATERIALS A PubMed search of English language articles from 1979 to 2008 was performed, yielding 33 articles with 56 patients who had available data regarding RT treatment field. The median age at diagnosis was 2.7 years (range, 1 month-53 years). Of 54 patients with data regarding type of surgery, 21 (38.9%) had complete resection. Chemotherapy was delivered to 27 (48%) as part of initial therapy. The RT treatment volume was the craniospinal axis in 38 (68%), whole brain in 9 (16%), and tumor/tumor bed in 9 (16%). Median follow-up for surviving patients was 40 months. RESULTS The 5-year overall survival and progression-free survival (PFS) rates were 59.5% and 37.2%, respectively. Complete resection (p = 0.035) and use of craniospinal irradiation (CSI; p = 0.025) were found to positively affect PFS. The 5-year PFS for patients who had CSI vs. whole brain and tumor/tumor bed RT were 44.2% and 15.3%. For the 19 patients who relapsed, 9 (47%) had a recurrence in the RT field, 6 (32%) had a recurrence outside the RT field, and 4 (21%) had a recurrence inside and outside the irradiated field. CONCLUSION Patients with CPC who received CSI had better PFS compared with those receiving less than CSI. This study supports the use of CSI in the multimodality management of patients with CPC.
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Affiliation(s)
- Ali Mazloom
- Department of Radiation Oncology, The Methodist Hospital, and The Methodist Hospital Research Institute, Houston, TX 77030, USA
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Lozier AP, Arbaje YM, Scheithauer BW. SUPRATENTORIAL, EXTRAVENTRICULAR CHOROID PLEXUS CARCINOMA IN AN ADULT. Neurosurgery 2009; 65:E816-7. [DOI: 10.1227/01.neu.0000348291.48810.c2] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Abstract
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.
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Affiliation(s)
- Alan P. Lozier
- Department of Neurosurgery, Dean Clinic, Madison, Wisconsin
| | | | - Bernd W. Scheithauer
- Department of Pathology and Laboratory Medicine, Mayo Clinic, Rochester, Minnesota
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