Surgical outcomes in choroid plexus papillomas: an institutional experience

Abstract

Choroid plexus papillomas (CPPs) are rare, indolent lesions that comprise less than 0.5 % of intracranial tumors. We sought to assess the long-term outcomes and associated surgical complications at our institution. A review of the University of California, San Francisco (UCSF) Brain Tumor Research Center (BTRC) database was performed to identify a cohort of patients treated for CPP from 1997 to 2011. Patients were grouped based on tumor location and extent of resection. Outcomes including progression-free survival and surgical complications were assessed. We identified 24 patients (16 female, 8 male) ranging in age from 6 months to 55 years (median 29 years) treated at our institution. Tumors were found in the following locations: 16 (67 %) fourth ventricle/cerebellopontine angle; 7 (29 %) lateral ventricle; 1 (4 %) third ventricle. Gross total resection (GTR) was achieved in 20 patients (83 %) with subtotal resection (STR) in 4 (17 %). Median follow-up time was 2.8 years with 3 recurrences identified at 1.6, 3.3, and 8.5 years. Extent of resection and tumor location were not associated with recurrence. There was one new permanent neurologic deficit detected after surgery. All patients were alive at most recent follow-up. Attempted gross total resection is the standard treatment for CPPs and generally associated with excellent outcomes. Since recurrences are rare, even among patients who undergo STR, radiation may be reserved for cases of tumor progression. This modern experience at a tertiary care center performed exclusively during the MRI-era demonstrates that CPPs can be safely removed with minimal morbidity and good tumor control.

Case series of choroid plexus papilloma in children at uncommon locations and review of the literature

“…[ 2 15 25 ] Although, a few studies have shown a higher incidence in females, the majority have shown no such predilection. [ 2 34 37 ] However, in our series, all were males in the first decade. These neoplasms present with features of raised ICP (because of hydrocephalus) or compressive effects on adjacent tissues.…”

“…[ 10 17 21 25 38 ] Surgical removal is the treatment of choice, and surgical approaches need to be tailored according to the location, size, and extent of the lesion. [ 12 34 41 ] Authors report three cases of CPP in pediatric age group located in uncommon locations such as the posterior third ventricle, fourth ventricle, and CP angle. The diagnostic dilemma and management issues are discussed along with a review of the literature.…”

An extremely rare case of choroid plexus carcinoma in third ventricle of an infant – Case report and review of literature

“…14% of choroid plexus tumors occur during infancy although there are reports of third ventricle choroid plexus papilloma during 5 th decade of life (19,20). In majority of reports there is no reported sex predilection in CPTs (21,22). CPCs are almost 4 fold more common in children than adults (12).…”

“…Because of small diameters and complex neuroanatomy of third ventricle, resection of tumors in this area are challenging and highly demands expertise (32). Due to high vascularity of these tumors significant blood loss during resection should be anticipated and effectively managed specially in pediatric population (7,11,21,25). Blood loss can be limited by initial finding and securing of arterial feeders which are branches of adjacent choroidal arteries and subsequent coagulation and en-bloc or piecemeal removal of tumor bulk (7,10,24).…”

Cerebellopontine angle Choroid plexus papilloma various presentations: report of series and literature review

“…Choroid plexus tumors (CPTs) are rare intraventricular neuroectoderm neoplasms derived from the choroid plexus epithelium 24,32,36 . According to the 2007 WHO Classification of Tumors of the Central Nervous System, primary CPTs are classified as choroid plexus papilloma (CPP, WHO grade I,80%), atypical CPP (WHO grade II,15%) and choroid plexus carcinoma (CPC, WHO grade III, less than 5%) 8,18 .…”