Abstract
Choroid plexus papillomas (CPPs) are benign but rare neuroepithelial neoplasms of the choroid plexus that represent the non-malignant form of a spectrum of tumors of the choroid plexus. The vast majority of CPPs present in children under 5 years of age. Some CPPs are diagnosed prenatally, but many of them reach a large size before diagnosis. CPPs typically present with signs and symptoms of hydrocephalus. Treatment of these tumors has traditionally been with surgical resection. Large CPPs in young children present a challenge due to risk of high blood loss during resection. Here, the authors describe the case of a 3-month-old presenting with hydrocephalus and a large CPP of the third ventricle that was managed with a staged strategy of embolization followed by a delayed resection, allowing the tumor to involute prior to surgery.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
Data availability
All data are included within the submission.
References
Aljared T, Farmer JP, Tampieri D (2016) Feasibility and value of preoperative embolization of a congenital choroid plexus tumour in the premature infant: an illustrative case report with technical details. Interv Neuroradiol 22:732–735. https://doi.org/10.1177/1591019916665346
Bahar M, Hashem H, Tekautz T, Worley S, Tang A, de Blank P, Wolff J (2017) Choroid plexus tumors in adult and pediatric populations: the Cleveland Clinic and University Hospitals experience. J Neurooncol 132:427–432. https://doi.org/10.1007/s11060-017-2384-1
Do HM, Marx WF, Khanam H, Jensen ME (2001) Choroid plexus papilloma of the third ventricle: angiography, preoperative embolization, and histology. Neuroradiology 43:503–506. https://doi.org/10.1007/s002340000470
Due-Tonnessen B, Helseth E, Skullerud K, Lundar T (2001) Choroid plexus tumors in children and young adults: report of 16 consecutive cases. Childs Nerv Syst 17:252–256. https://doi.org/10.1007/pl00013728
Ghatak NR, McWhorter JM (1976) Ultrastructural evidence for CSF production by a choroid plexus papilloma. J Neurosurg 45:409–415. https://doi.org/10.3171/jns.1976.45.4.0409
Haliasos N, Brew S, Robertson F, Hayward R, Thompson D, Chakraborty A (2013) Pre-operative embolisation of choroid plexus tumours in children. Part II. Observations on the effects on CSF production. Childs Nerv Syst 29:71–76. https://doi.org/10.1007/s00381-012-1913-7
Haliasos N, Brew S, Robertson F, Hayward R, Thompson D, Chakraborty A (2013) Preoperative embolisation of choroid plexus tumours in children: part I-does the reduction of perioperative blood loss affect the safety of subsequent surgery? Childs Nerv Syst 29:65–70. https://doi.org/10.1007/s00381-012-1912-8
Ishihara H, Ishihara S, Niimi J, Neki H, Kakehi Y, Uemiya N, Kohyama S, Yamane F, Kato H, Suzuki T, Adachi J, Mishima K, Nishikawa R (2015) The safety and efficacy of preoperative embolization of meningioma with N-butyl cyanoacrylate. Interv Neuroradiol 21:624–630. https://doi.org/10.1177/1591019915590537
Jung GS, Ruschel LG, Leal AG, Ramina R (2016) Embolization of a giant hypervascularized choroid plexus papilloma with onyx by direct puncture: a case report. Childs Nerv Syst 32:717–721. https://doi.org/10.1007/s00381-015-2915-z
Kennedy BC, Cloney MB, Anderson RC, Feldstein NA (2015) Superior parietal lobule approach for choroid plexus papillomas without preoperative embolization in very young children. J Neurosurg Pediatr 16:101–106. https://doi.org/10.3171/2014.11.PEDS14281
Lin H, Leng X, Qin CH, Du YX, Wang WS, Qiu SJ (2019) Choroid plexus tumours on MRI: similarities and distinctions in different grades. Cancer Imaging 19:17. https://doi.org/10.1186/s40644-019-0200-1
Louis DN, Perry A, Reifenberger G, von Deimling A, Figarella-Branger D, Cavenee WK, Ohgaki H, Wiestler OD, Kleihues P, Ellison DW (2016) The 2016 World Health Organization Classification of Tumors of the Central Nervous System: a summary. Acta Neuropathol 131:803–820. https://doi.org/10.1007/s00401-016-1545-1
Otten ML, Riina HA, Gobin YP, Souweidane MM (2006) Preoperative embolization in the treatment of choroid plexus papilloma in an infant. Case report. J Neurosurg 104:419–421. https://doi.org/10.3171/ped.2006.104.6.419
Pietrini D, Ciano F, Forte E, Pusateri A, Valenti M, Zanghi F, Chiaretti A, Piastra M, Tamburrini G, Caldarelli M (2004) Massive blood loss during removal of congenital choroid plexus tumors. J Neurosurg Anesthesiol 16:260–263. https://doi.org/10.1097/00008506-200407000-00017
Siegfried A, Morin S, Munzer C, Delisle MB, Gambart M, Puget S, Maurage CA, Miquel C, Dufour C, Leblond P, Andre N, Branger DF, Kanold J, Kemeny JL, Icher C, Vital A, Coste EU, Bertozzi AI (2017) A French retrospective study on clinical outcome in 102 choroid plexus tumors in children. J Neurooncol 135:151–160. https://doi.org/10.1007/s11060-017-2561-2
Trivelato FP, Manzato LB, Rezende MT, Barroso PM, Faleiro RM, Ulhoa AC (2012) Preoperative embolization of choroid plexus papilloma with Onyx via the anterior choroidal artery: technical note. Childs Nerv Syst 28:1955–1958. https://doi.org/10.1007/s00381-012-1928-0
Wind JJ, Bell RS, Bank WO, Myseros JS (2010) Treatment of third ventricular choroid plexus papilloma in an infant with embolization alone. J Neurosurg Pediatr 6:579–582. https://doi.org/10.3171/2010.9.PEDS1039
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Consent to participate
Consent to publish clinical details of the patient was provided by the patient’s mother.
Competing interest
The authors have no financial relationships related to this article to disclose.
Additional information
Publisher’s note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
About this article
Cite this article
Mangham, W.M., Elijovich, L., Lee-Diaz, J.A. et al. Pre-operative embolization for staged treatment of infantile choroid plexus papilloma. Childs Nerv Syst 38, 429–433 (2022). https://doi.org/10.1007/s00381-021-05212-w
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00381-021-05212-w