Skip to main content

Advertisement

SpringerLink
Log in

Surgical outcomes in choroid plexus papillomas: an institutional experience

  • Clinical Study
  • Published:
Journal of Neuro-Oncology Aims and scope Submit manuscript

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Paulus W, Bradner S (2007) WHO Classification of Tumours of the Central Nervous System. IARC Press, Lyon

    Google Scholar 

  2. Krishnan S, Brown PD, Scheithauer BW, Ebersold MJ, Hammack JE, Buckner JC (2004) Choroid plexus papillomas: a single institutional experience. J Neurooncol 68:49–55

    Article  PubMed  Google Scholar 

  3. Wolff JE, Sajedi M, Brant R, Coppes MJ, Egeler RM (2002) Choroid plexus tumours. Br J Cancer 87:1086–1091. doi:10.1038/sj.bjc.6600609

    Article  PubMed  CAS  Google Scholar 

  4. Palazzi M, Di Marco A, Campostrini F, Grandinetti A, Bontempini L (1989) The role of radiotherapy in the management of choroid plexus neoplasms. Tumori 75:463–469

    PubMed  CAS  Google Scholar 

  5. Tacconi L, Delfini R, Cantore G (1996) Choroid plexus papillomas: consideration of a surgical series of 33 cases. Acta Neurochir (Wien) 138:802–810

    Article  CAS  Google Scholar 

  6. Hawkins JC 3rd (1980) Treatment of choroid plexus papillomas in children: a brief analysis of twenty years’ experience. Neurosurgery 6:380–384

    Article  PubMed  Google Scholar 

  7. Talacchi A, De Micheli E, Lombardo C, Turazzi S, Bricolo A (1999) Choroid plexus papilloma of the cerebellopontine angle: a twelve patient series. Surg Neurol 51:621–629

    Article  PubMed  CAS  Google Scholar 

  8. McGirr SJ, Ebersold MJ, Scheithauer BW, Quast LM, Shaw EG (1988) Choroid plexus papillomas: long-term follow-up results in a surgically treated series. J Neurosurg 69:843–849. doi:10.3171/jns.1988.69.6.0843

    Article  PubMed  CAS  Google Scholar 

  9. Menon G, Nair SN, Baldawa SS, Rao RB, Krishnakumar KP, Gopalakrishnan CV (2010) Choroid plexus tumors: an institutional series of 25 patients. Neurol India 58:429–435

    Article  PubMed  Google Scholar 

  10. Kato T, Fujita M, Sawamura Y, Tada M, Abe H, Nagashima K, Nakamura N (1996) Clinicopathological study of choroid plexus tumors: immunohistochemical features and evaluation of proliferative potential by PCNA and Ki-67 immunostaining. Noshuyo Byori 13:99–105

    PubMed  CAS  Google Scholar 

  11. Tena-Suck ML, Salinas-Lara C, Rembao-Bojorquez D, Castillejos M (2010) Clinicopathologic and immunohistochemical study of choroid plexus tumors: single-institution experience in Mexican population. J Neurooncol 98:357–365

    Article  PubMed  CAS  Google Scholar 

  12. Guidetti B, Spallone A (1981) The surgical treatment of choroid plexus papillomas: the results of 27 years experience. Neurosurg Rev 4:129–137

    Article  PubMed  CAS  Google Scholar 

  13. Wilkins H, Rutledge BJ (1961) Papillomas of the choroid plexus. J Neurosurg 18:14–18. doi:10.3171/jns.1961.18.1.0014

    Article  PubMed  CAS  Google Scholar 

  14. Pencalet P, Sainte-Rose C, Lellouch-Tubiana A, Kalifa C, Brunelle F, Sgouros S, Meyer P, Cinalli G, Zerah M, Pierre-Kahn A, Renier D (1998) Papillomas and carcinomas of the choroid plexus in children. J Neurosurg 88:521–528. doi:10.3171/jns.1998.88.3.0521

    Article  PubMed  CAS  Google Scholar 

  15. Piastra M, Di Rocco C, Tempera A, Caresta E, Zorzi G, Tosi F, Massimi L, Pietrini D (2007) Massive blood transfusion in choroid plexus tumor surgery: 10-years’ experience. J Clin Anesth 19:192–197. doi:10.1016/j.jclinane.2006.10.010

    Article  PubMed  Google Scholar 

  16. Kumar R, Singh S (2005) Childhood choroid plexus papillomas: operative complications. Childs Nerv Syst 21:138–143. doi:10.1007/s00381-004-0993-4

    Article  PubMed  Google Scholar 

  17. 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

    Article  PubMed  CAS  Google Scholar 

  18. El-Gaidi MA, Eissa EM (2010) Infantile intracranial neoplasms: characteristics and surgical outcomes of a contemporary series of 21 cases in an Egyptian referral center. Pediatr Neurosurg 46:272–282. doi:10.1159/000321540

    Article  PubMed  Google Scholar 

  19. Nagib MG, O’Fallon MT (2000) Lateral ventricle choroid plexus papilloma in childhood: management and complications. Surg Neurol 54:366–372

    Article  PubMed  CAS  Google Scholar 

  20. Levy ML, Goldfarb A, Hyder DJ, Gonzales-Gomez I, Nelson M, Gilles FH, McComb JG (2001) Choroid plexus tumors in children: significance of stromal invasion. Neurosurgery 48:303–309

    PubMed  CAS  Google Scholar 

  21. Hess DR (2004) Retrospective studies and chart reviews. Respiratory care 49:1171–1174

    PubMed  Google Scholar 

  22. Tabori U, Shlien A, Baskin B, Levitt S, Ray P, Alon N, Hawkins C, Bouffet E, Pienkowska M, Lafay-Cousin L, Gozali A, Zhukova N, Shane L, Gonzalez I, Finlay J, Malkin D (2010) TP53 alterations determine clinical subgroups and survival of patients with choroid plexus tumors. Journal of clinical oncology: official journal of the American Society of Clinical Oncology 28:1995–2001. doi:10.1200/JCO.2009.26.8169

    Article  CAS  Google Scholar 

  23. Custodio G, Taques GR, Figueiredo BC, Gugelmin ES, Oliveira Figueiredo MM, Watanabe F, Pontarolo R, Lalli E, Torres LF (2011) Increased incidence of choroid plexus carcinoma due to the germline TP53 R337H mutation in southern Brazil. PLoS ONE 6:e18015. doi:10.1371/journal.pone.0018015

    Article  PubMed  CAS  Google Scholar 

  24. Rickert CH, Wiestler OD, Paulus W (2002) Chromosomal imbalances in choroid plexus tumors. Am J Pathol 160:1105–1113. doi:10.1016/S0002-9440(10)64931-0

    Article  PubMed  Google Scholar 

  25. Losi-Guembarovski R, Kuasne H, Guembarovski AL, Rainho CA, Colus IM (2007) DNA methylation patterns of the CDH1, RARB, and SFN genes in choroid plexus tumors. Cancer Genet Cytogenet 179:140–145. doi:10.1016/j.cancergencyto.2007.05.029

    Article  PubMed  CAS  Google Scholar 

  26. Safaee M, Oh MC, Bloch O, Sun MZ, Kaur G, Auguste KI, Tihan T, Parsa AT (2012) Choroid plexus papillomas: advances in molecular biology and understanding of tumorigenesis. Neuro-oncology. doi:10.1093/neuonc/nos289

    Google Scholar 

  27. Koos B, Paulsson J, Jarvius M, Sanchez BC, Wrede B, Mertsch S, Jeibmann A, Kruse A, Peters O, Wolff JE, Galla HJ, Soderberg O, Paulus W, Ostman A, Hasselblatt M (2009) Platelet-derived growth factor receptor expression and activation in choroid plexus tumors. Am J Pathol 175:1631–1637. doi:10.2353/ajpath.2009.081022

    Article  PubMed  CAS  Google Scholar 

  28. Hasselblatt M, Bohm C, Tatenhorst L, Dinh V, Newrzella D, Keyvani K, Jeibmann A, Buerger H, Rickert CH, Paulus W (2006) Identification of novel diagnostic markers for choroid plexus tumors: a microarray-based approach. American J Surg Pathol 30:66–74

    Article  Google Scholar 

  29. Hasselblatt M, Mertsch S, Koos B, Riesmeier B, Stegemann H, Jeibmann A, Tomm M, Schmitz N, Wrede B, Wolff JE, Zheng W, Paulus W (2009) TWIST-1 is overexpressed in neoplastic choroid plexus epithelial cells and promotes proliferation and invasion. Cancer Res 69:2219–2223. doi:10.1158/0008-5472.CAN-08-3176

    Article  PubMed  CAS  Google Scholar 

  30. Dang L, Fan X, Chaudhry A, Wang M, Gaiano N, Eberhart CG (2006) Notch3 signaling initiates choroid plexus tumor formation. Oncogene 25:487–491. doi:10.1038/sj.onc.1209074

    PubMed  CAS  Google Scholar 

  31. Michalowski MB, de Fraipont F, Michelland S, Entz-Werle N, Grill J, Pasquier B, Favrot MC, Plantaz D (2006) Methylation of RASSF1A and TRAIL pathway-related genes is frequent in childhood intracranial ependymomas and benign choroid plexus papilloma. Cancer Genet Cytogenet 166:74–81. doi:10.1016/j.cancergencyto.2005.09.004

    Article  PubMed  CAS  Google Scholar 

Download references

Acknowledgments

Mr. Safaee was supported by a grant from the Doris Duke Charitable Foundation. Dr. Parsa was partially funded by the Reza and Georgianna Khatib Endowed Chair in Skull Base Tumor Surgery.

Conflict of interest

  The authors declare that they have no conflict of interest.

Author information

Authors and Affiliations

  1. Department of Neurological Surgery, University of California at San Francisco, 505 Parnassus Ave, San Francisco, CA, 94117, USA

    Michael Safaee, Aaron J. Clark, Orin Bloch, Michael C. Oh, Anahat Singh, Kurtis I. Auguste, Nalin Gupta, Michael W. McDermott, Manish K. Aghi, Mitchel S. Berger & Andrew T. Parsa

  2. Department of Pediatrics, University of California at San Francisco, San Francisco, CA, USA

    Kurtis I. Auguste & Nalin Gupta

Authors
  1. Michael Safaee
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Aaron J. Clark
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Orin Bloch
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Michael C. Oh
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Anahat Singh
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Kurtis I. Auguste
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Nalin Gupta
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Michael W. McDermott
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Manish K. Aghi
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Mitchel S. Berger
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Andrew T. Parsa
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Andrew T. Parsa.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Safaee, M., Clark, A.J., Bloch, O. et al. Surgical outcomes in choroid plexus papillomas: an institutional experience. J Neurooncol 113, 117–125 (2013). https://doi.org/10.1007/s11060-013-1097-3

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11060-013-1097-3

Keywords

Search

Navigation