Choroid plexus papilloma of the fourth ventricle: A pediatric patient

Abstract

Choroid plexus papilloma is a low-frequency entity in both the adult and pediatric populations. Its clinical presentation is very variable as it depends on its location and length. We must always do the differential diagnosis between papilloma and other intraventricular pathologies. This article is about a case report of a pediatric patient with a Choroid plexus papilloma located in the fourth ventricle, a location that is atypical for the pediatric population.

A rare trifocal presentation of a choroid plexus papilloma: Case report and review of the literature

“…In about 25% of cases, speckled ossification inside the tumor can be seen, as was the case in our patient ( Anh Tuan et al, 2021 ). Initial misdiagnosis, as was the case in our patient, is common due to their varying clinical and radiographic presentation, a higher incidence of other brain neoplasms (such as ependymoma, medulloblastoma and pilocytic astrocytoma) and intralesional calcifications more commonly encountered in other brain neoplasms (only in 25% of CPP ( Safaee et al, 2013 ; Muñoz Montoya et al, 2019 )) ( Anh Tuan et al, 2021 ; Muñoz Montoya et al, 2019 ). Perhaps the most challenging differential diagnosis is the one with ependymoma.…”

“…Choroid plexus papilloma's (CPP) mostly present as slow-growing intraventricular neoplasms of neuroepithelial origin arising from the epithelium of the choroid plexus ( Anh Tuan et al, 2021 ; Thomas et al, 2021 ; Bian et al, 2011 ; Turkoglu et al, 2014 ; Peyre et al, 2012 ; Hosmann et al, 2019 ). They account for approximately 1% of brain neoplasms in all age groups, of which 0.5% and 4% of intracranial neoplasms in adults and children, respectively ( Anh Tuan et al, 2021 ; Turkoglu et al, 2014 ; Wolff et al, 2002 ; Browne-Farmer et al, 2021 ; Muñoz Montoya et al, 2019 ). Previously, it was thought that these tumors were most commonly seen in the pediatric population of which 70% of cases have been identified in patients under the age of two years old ( Anh Tuan et al, 2021 ; Browne-Farmer et al, 2021 ).…”

“…In children, CPP's are mostly located supratentorial in the atrium of the lateral ventricles, while in adults they mostly are found infratentorial of which 70% are found in the fourth ventricle ( Anh Tuan et al, 2021 ; Bian et al, 2011 ; Turkoglu et al, 2014 ; Muñoz Montoya et al, 2019 ; Gong et al, 2017 ). Supratentorial lesions occur at a median age of one and a half years, whereas infratentorial tumors present at a median age of twentytwo years ( Turkoglu et al, 2014 ).…”

“…Moreover, there seems to be a caudal progression of localization with age, since an infratentorial presentation is mostly seen in older children ( Browne-Farmer et al, 2021 ). However, extraventricular locations have been described, such as pineal region, cerebellopontine angle (Bochdaleck's flower basket), brainstem, sellar and suprasellar region ( Bian et al, 2011 ; Peyre et al, 2012 ; Muñoz Montoya et al, 2019 ; Gong et al, 2017 ; Kuo et al, 2018 ; Sameshima et al, 2010 ; Ma et al, 2008 ). Probably, these lesions develop from embryonic rests of choroid plexus, since both ependymal and choroid plexus cells have the same embryonic origin ( Bian et al, 2011 ).…”

Choroid Plexus Papilloma of the Fourth Ventricle in a Pediatric Patient: A Case Report

“…In addition to that, even though it can appear at any age, 70% of the cases in the pediatric population occur in children younger than two years old [ 1 , 4 , 5 ]. CCP is a benign disease in 80% of patients with a good prognosis [ 6 ]. In this study, we present a rare case of a child with choroid plexus papilloma in the fourth ventricle.…”