Disseminated choroid plexus papillomas in adults: A case series and review of the literature

Abdulkader, Marwah M.; Mansour, Nassir M.; Gompel, Jamie J. Van; Bosh, Gregory A.; Dropcho, Edward J.; Bonnin, José M.; Cohen-Gadol, Aaron

doi:10.1016/j.jocn.2016.04.002

Cited by 19 publications

(13 citation statements)

References 26 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Whereas metastatic disease in CPC is common [9, 47], dissemination of CPP or aCPP is very rare and has been reported in only a few cases so far [1, 32, 49]. We observed cranio-spinal leptomeningeal dissemination at recurrence in one adult fourth ventricular aCPP patient (9% of aCPP) with only STR at initial surgery.…”

Section: Discussionmentioning

confidence: 76%

Management of choroid plexus tumors—an institutional experience

et al. 2019

View full text Add to dashboard Cite

BackgroundChoroid 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.MethodsRetrospective 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.ResultsTwenty-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.ConclusionsWe 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.

show abstract

Section: Discussionmentioning

confidence: 76%

Management of choroid plexus tumors—an institutional experience

et al. 2019

View full text Add to dashboard Cite

show abstract

“…CPPs are low-grade tumors classified as grade I in the World Health Organization (WHO) grading scheme. [ 1 ] By incorporating genetic analysis, the current histologic grading scheme could be refined to create a more accurate, clinically relevant system for categorizing choroid plexus tumors. [ 9 ]…”

Section: Discussionmentioning

confidence: 99%

“…Choroid plexus papillomas (CPPs) are primary neuroectodermal tumors of the choroid plexus and rarely located in the cerebellopontine angle (CPA). [ 1 ] They are usually not malignant and occur in less than 1% of brain tumors in patients of all ages, but more commonly found in pediatric patients. [ 2 ] CPPs predominantly arise in supratentorial locations in children, while the most common sites in adults were the fourth ventricle and the CPA.…”

Section: Introductionmentioning

confidence: 99%

Choroid plexus papilloma presenting as an occipital mass with neck pain

Tang

Bian

Jiang³

et al. 2018

Medicine

View full text Add to dashboard Cite

Rationale:Choroid plexus papillomas are rare benign central nervous system neoplasms arising from choroid plexus epithelium. They are most often located in the lateral ventricle, followed by the fourth and third ventricles and, rarely, in the cerebellopontine angle.Patient concerns:We report an uncommon case of a 17-year-old boy who presented with neck pain that had lasted for more than 1 month, with accompanying pain and numbness in his upper extremities. His conditions included slight dizziness, nausea, diplopia, paresthesia, and an unsteady gait. Magnetic resonance imaging (MRI) showed huge cerebellopontine angle tumor that extended to the front medulla oblongata.Diagnosis:Choroid plexus papilloma (WHO I) was diagnosed in this patient.Interventions:The patient was referred for neurosurgical intervention. The very large neoplasm was subtotally resected.Outcomes:The symptoms of the patient were gradually alleviated after surgery and subsequent radiotherapy treatment, but unfortunately, follow-up of 2 years later revealed that the disease was recurrent and the young man passed away.Lessons:Neck pain is related to many factors. The case provided an awareness of the origin of severe intracranial disease. It is mandatory to take a thorough clinical assessment with a holistic approach.

show abstract

“…Yet, in adult patients, there are several examples demonstrating that benign CPP can form distant metastases. [1][2][3][4][5][6][8][9][10][12][13][14][16][17][18][19][22][23][24][25][26][27][31][32][33][34][35][36]38,39 A review of the literature demonstrated 35 cases in adults (age range 19-74 years, mean 40.3 years; 14 males, 19 females, and 2 patients in whom sex and age were not reported) ( Table 1). These included cases in which the metastatic…”

Section: Discussionmentioning

confidence: 99%

“…lesions demonstrated progression to atypical CPPs 26,33,38 or retained benign features similar to those of the original primary lesion. 1,2,4,9,[16][17][18]22,23,25,27,31,33,39 Furthermore, these metastatic lesions were found within the ventricular sys-tem, posterior fossa (including the cerebellopontine angle), or anterior or middle cranial fossa; diffusely involving the leptomeninges; or along the spinal axis.…”

Section: Fig 2 Photomicrographs Amentioning

confidence: 99%

Spinal drop metastasis from a benign fourth ventricular choroid plexus papilloma in a pediatric patient: case report

Morshed

Lau

Sun

et al. 2017

Journal of Neurosurgery: Pediatrics

View full text Add to dashboard Cite

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.

show abstract

Disseminated choroid plexus papillomas in adults: A case series and review of the literature

Cited by 19 publications

References 26 publications

Management of choroid plexus tumors—an institutional experience

Management of choroid plexus tumors—an institutional experience

Choroid plexus papilloma presenting as an occipital mass with neck pain

Spinal drop metastasis from a benign fourth ventricular choroid plexus papilloma in a pediatric patient: case report

Contact Info

Product

Resources

About