Persistence of communicating hydrocephalus post choroid plexus tumor resection: Case reports and review of literature

Background: Hydrocephalus is the most common presentation of choroid plexus tumors; it is thought to be caused either by mass effect obstructing the cerebrospinal fluid pathways or secretory properties of the tumor. In these case reports, we present two cases of choroid plexus tumors with persistence of communicating hydrocephalus postoperatively and review similar reports in the literature. Case Description: Case 1: a 2-month-old baby girl presented with bulging fontanelle, sunsetting eyes. Magnetic resonance imaging (MRI) showed large third ventricle mass with communicating hydrocephalus. She underwent complete excision of tumor through transcortical approach with perioperative intraventricular hemorrhage. Hydrocephalus persisted postoperatively and the patient required permanent ventriculoperitoneal (VP) shunt. Case 2: a 16-year-old boy presented decreased visual acuity, papilledema, and morning headaches. MRI showed a tumor in the right ventricle and communicating hydrocephalus. He underwent transparietal resection of the tumor. In both cases, hydrocephalus persisted postoperatively and patients required permanent VP shunt. Review of similar cases showed the majority of cases required permanent shunting. Conclusion: Choroid plexus tumor patients can present with communicating hydrocephalus that may persist post tumor resection for different etiologies. Careful follow-up to determine the need for cerebrospinal fluid diversion through a permanent VP shunt is important.

Pediatric Case of Li–Fraumeni Syndrome in Honduras

Li–Fraumeni syndrome is an inherited, autosomal dominant disease. It is categorized as a rare disease caused by mutations of the TP53 gene, which causes increased susceptibility of the patients and their children to many types of cancer. Choroid plexus tumor is rare, which occurs in 0.3 cases per 1,000,000 people, of which 40% turn out to be carcinomas. We present a 12-year-old boy with a history of worsening headaches of more than one month, gait disturbance, projectile vomiting, and right hemiparesis. An intraventricular tumor was identified in the occipital of the left lateral ventricle, which turned out to be a TP53-mutant choroidal plexus carcinoma.

Long-Term Outcome After Surgical Resection of a Spinal Choroid Plexus Tumor in a Dog

ABSTRACT A 6 yr old castrated male Clumber spaniel was referred for evaluation of acute paraplegia. MRI of the thoracolumbar spine demonstrated an intradural-extramedullary mass lesion at the level of T12 and extradural spinal cord compression at L1–L2. A hemilaminectomy was performed to achieve gross total resection of the mass lesion and removal of extruded disc material. A diagnosis of spinal choroid plexus tumor (CPT) and intervertebral disc extrusion was made. At 4 mo postoperatively, MRI demonstrated a mass lesion at the right lateral aperture of the fourth ventricle. Spinal drop metastasis from a primary intracranial CPT was suspected. The dog was ambulating independently and neurologically normal at that time. At 17 mo postoperatively, a third MRI was performed owing to decreased postural reactions in both hind limbs and vision loss in the right eye, and it demonstrated an increase in size of the intracranial mass lesion. These two additional MRI studies of the entire central nervous system showed no other metastatic lesions nor any evidence of local recurrence. At 25 mo postoperatively, the dog died at home. This is the first case report of surgical intervention and antemortem histopathological diagnosis of a spinal CPT in a dog.

Transcallosal Interforniceal Approach for a Large Choroid Plexus Tumor in a 4-Month-Old Boy: 2-Dimensional Operative Video

Tumors in the third ventricle constitute a challenge for the neurosurgeon, regardless of the chosen approach. The additional risk of severe blood loss in the pediatric population, specially for choroid plexus tumors, which are the most common ventricular tumors in children, adds a significant challenge in these cases. Therefore, a careful selection of the approach in addition to surgical technique is crucial for a favorable outcome. In this video, we discuss the approach selected for the treatment of a large choroid plexus tumor in a 4-mo-old male and highlight the surgical technique chosen for this case, a transcallosal interforniceal approach.1 Appropriate consent for the video authorization and the procedure was obtained from the parent of the patient. Images in video from Rhoton AL Jr, The Cerebrum, Neurosurgery, 2007, 61, suppl_1, SHC-37-SHC-119, by permission of the Congress of Neurological Surgeons.

Correction to: DNA methylation signature is prognostic of choroid plexus tumor aggressiveness

After publication of the original article [1], authors have requested to add a ‘J’ as middle name for Richard Gilbertson. Hence, full name should be Richard J Gilbertson.

Cerebrospinal fluid cytology of choroid plexus tumor: A report of two cases

Choroid plexus tumors (CPTs) are relatively uncommon tumors of the central nervous system, constituting approximately 5% of all pediatric brain tumors. Although squash cytology of CPT has been described in literature, shedding of tumor cells into cerebrospinal fluid (CSF) has rarely been described. We report two such cases of atypical choroid plexus papilloma in a 5-month-old male child and a 12-year-old female child, where characteristic cytomorphology of CPT was noted in the CSF.

Immunohistochemical Analysis of Cerebral Intraparenchymal Choroid Plexus Tumor: Case Report

Background It is very rare for a choroid plexus tumor to occur intraparenchymally in the absence of a relation to the choroid plexus. Clinical Presentation A case of cerebral intraparenchymal choroid plexus tumor in a 30-year-old woman presenting with left hemiparesis is described. Brain magnetic resonance imaging depicted a large cystic mass in the right frontal lobe. Tumor resection was performed by right frontal craniotomy. No connection with the choroid plexus was observed during the operation. Histologically, the tumor exhibited a glandular structure with a papillary pattern suggesting a neoplasm of epithelial origin. Immunohistochemical analyses revealed the tumor as an atypical choroid plexus papilloma. Conclusion Immunohistochemical findings, especially regarding Kir7.1, are very important for the differential diagnosis of cerebral intraparenchymal choroid plexus tumors from metastatic tumors. The present case reveals that an atypical choroid plexus papilloma can occur intraparenchymally without an association with the choroid plexus. Intraparenchymal atypical choroid plexus papillomas may have previously been diagnosed incorrectly as metastatic adenocarcinomas of unknown origin.