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A case report of hydrocephalus due to diffuse villous hyperplasia of the choroid plexus: surgical treatment by combination a flexible videoscope with a rigid endoscope

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Abstract

Purpose

Diffuse villous hyperplasia of the choroid plexus (DVHCP) and choroid plexus papilloma (CPP) are rare benign tumors usually diagnosed as a result of progressive hydrocephalus, especially in childhood. We present the case of a Japanese boy diagnosed with progressive hydrocephalus due to DVHCP.

Methods

Case: A 2-year and 3-month-old Japanese boy was found to have delayed motor development (equivalent to 1 year and 2 months old), an enlarged head circumference of 51 cm within + 1.5 standard deviation (S.D.), and incomplete closure of the anterior fontanel. The magnetic resonance imaging (MRI) showed lobular enlargement of the bilateral choroid plexuses extending from the trigone to the body and inferior horn of the lateral ventricle. The endoscopic choroid plexus coagulation surgery was performed to reduce the CSF formation rate.

Results

DVHCP was diagnosed both pathologically and clinically. Postoperatively, the patient progressed without complications, such as cerebrospinal fluid leakage. Although ventricular enlargement persisted, the anterior fontanel recessed, and the expansion of the head circumference stopped.

Conclusion

Few cases of bilateral DVHCP and CPP have been reported in the literature. We encountered a case in which effective choroid plexus coagulation was performed for hydrocephalus due to DVHCP using less invasive endoscopic technique. It also represented an association between DVHCP and the gain of chromosome 9p.

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Data availability

The data that support the findings of this study are available from the corresponding author Takuji Yamamoto, upon reasonable request.

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Acknowledgements

We thank all the physicians involved in the care of patients at Juntendo Shizuoka Hospital and the children and families who allow us to serve as a part of their care pathway. We thank Mr. Taichi Hiramatsu, Mr. Makoto Kamiyama (BML, INC. Morphology Analysis Division Cytogrnitics Section) for their technical support. We also thank Editage (www.editage.jp) for the English language review.

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Authors and Affiliations

  1. Department of Neurosurgery, Juntendo University Shizuoka Hospital, Izunokuni City, Shizuoka, Japan

    Shintaro Nakajima, Keisuke Murofushi, Yasuaki Nakao & Takuji Yamamoto

  2. Department of Pediatrics, Juntendo University Shizuoka Hospital, Izunokuni City, Shizuoka, Japan

    Shinpei Matsuda & Shino Shimada

  3. Department of Neurosurgery, International University of Health and Welfare Hospital, Narita City, Chiba, Japan

    Kazuaki Shimoji

Authors
  1. Shintaro Nakajima
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  2. Keisuke Murofushi
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  3. Shinpei Matsuda
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  4. Shino Shimada
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  5. Kazuaki Shimoji
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  6. Yasuaki Nakao
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  7. Takuji Yamamoto
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Contributions

Shintaro Nakajima wrote the main manuscript text and prepared all figures and tables. Murofushi Keisuke, Shinpei Matsuda, Shino Shimada, Kazuaki Shimoji, Yasuaki Nakao, Takuji Yamamoto reviewed the manuscript.

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Correspondence to Takuji Yamamoto.

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Nakajima, S., Murofushi, K., Matsuda, S. et al. A case report of hydrocephalus due to diffuse villous hyperplasia of the choroid plexus: surgical treatment by combination a flexible videoscope with a rigid endoscope. Childs Nerv Syst 39, 2045–2051 (2023). https://doi.org/10.1007/s00381-023-06012-0

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