A retrospective analysis of five adult patients with choroid plexus tumor(four choroids plexus papillomas, one choroids plexus carcinoma who underwent surgical resection at our institute between February 1991 and October 1995 was performed. The study group included two males and three females with a mean age of 34.0 years(range 21 to 24 years). Two of four choroids plexus papillomas were removed gross totally and one of these was irradiated postoperatively. The remaining two patients with choroids plexus papilloma underwent a subtotal surgical resection and one of them received radiation therapy. During follow-up, the authors could not find any difference in the size of the residual tumor or in the patient's KPS between the irradiated groups. There was also no response to postoperative radiation therapy in a patient with choroids plexus carcinoma who underwent a subtotal resection. The author's clinical experiences suggest that the use of radiation therapy in adult patients with choroids plexus tumor is not effective, and thus gross total resection should be attempted during the primary operation of such tumors.
Adult* ; Choroid Plexus Neoplasms* ; Choroid Plexus* ; Choroid* ; Female ; Follow-Up Studies ; Humans ; Male ; Neoplasm, Residual ; Papilloma ; Papilloma, Choroid Plexus ; Retrospective Studies

Transient mutism has ben known as a rare complication following a posterior fossa approach to cerebellar tumors, although its pathophysiology remains unclear. Cerebellar mutism may be defined as a transient mutism occurring after a posterior fossa tumor approach in children with unimpaired consciousness, unimpaired symbolic functions, no detectable deficit of cranial nerves or peripheral organs of speech, and no lesions of long pathways in the course of the cranial nerves at the level of the brain stem. Forty two cases in children, and only two cases in adults have been found in the literature. We report a case of transient mutism with oropharyngeal apraxia after total excision of 4th ventricle choroids plexus papilloma in a 6-year-old girl. Postoperatively, the patient became mute and refused food intake without disturbance of consciousness, or lower cranial nerve function. Computed tomography(CT) and magnetic resonance image(MRI) demonstrated no abnormal findings except the surgical lesion in the posterior fossa. The mutism lasted for 3 weeks, but she gradually became fluent. The mechanism of "cerebellar mutism" is briefly discussed with literature review.
Adult ; Apraxias ; Brain Stem ; Cerebellar Neoplasms ; Child* ; Choroid Plexus* ; Choroid* ; Consciousness ; Cranial Nerves ; Eating ; Female* ; Humans ; Infratentorial Neoplasms ; Mutism* ; Papilloma ; Papilloma, Choroid Plexus*

Choroid plexus papilloma(CPP) is a rare intraventricular neoplasm occurring primarily in the lateral ventricle of children and the 4th ventricle of adults. The 3rd ventricle is an extremely rare site for CPP to occur. The authors report two cases of CPP of the 3rd ventricle in a 2-month-old girl and a 4-month-old boy, and one case of CPP of the 4th ventricle in a 17-year-old male. Two CPP of third ventricle were totally removed by transcortical-transventricular approach and transcallosal subchoroidal approach, respectively. The CPP in the fourth ventricle was totally removed by suboccipital approach. The subdural hygroma and hydrocephalus due to CSF overproduction was managed with subduroperitoneal shunt and ventriculoperitoneal shunt.
Adolescent ; Adult ; Cerebral Ventricle Neoplasms ; Child ; Choroid Plexus* ; Choroid* ; Female ; Fourth Ventricle* ; Humans ; Hydrocephalus ; Infant ; Lateral Ventricles ; Male ; Papilloma, Choroid Plexus* ; Subdural Effusion ; Third Ventricle ; Ventriculoperitoneal Shunt

PURPOSE: Choroid Plexus papilloma is a rare intracranial neoplasm that is most commonly found in the trigone of the lateral ventricle in children or in the fourth ventricle in adult. Extraventricular extension of choroid plexus papilloma has been rarely reported within the cerebellopontine angle (CPA) cistern. Authors report two cases of choroid plexus papilloma in the posterior fossa seen on magnetic resonance imaging (MRI). MATERIALS AND METHODS: MRI findings of two cases of choroid plexus papilloma in posterior fossa were retrospectively reviewed. RESULTS: In the first case, the tumor was in the fourth ventricle and extended to the left CPA cistern via the foramen of Luschka. In the second case, the tumor presented as an expansile mass of the of fourth ventricle and right lateral recess. Multiple signal voids of low intensity due to prominent feeding vessels and calcifications within the tumors were noted. CONCLUSION: This report demonstrates MR findings of choroid plexus papilloma in the posterior fossa with the brief review of the literatures.
Adult ; Brain Neoplasms ; Cerebellopontine Angle ; Child ; Choroid Plexus* ; Choroid* ; Fourth Ventricle ; Humans ; Lateral Ventricles ; Magnetic Resonance Imaging ; Papilloma, Choroid Plexus* ; Retrospective Studies

Choroid plexus carcinoma (CPC), a frankly malignant epithelial neoplasm derived from choroid plexus epithelium, is a rare tumor with a predilection for infants and children. It may be difficult to histologically differentiate it from choroid plexus papilloma, anaplastic ependymoma, medulloblastoma, germ cell tumors, and metastatic carcinoma. We examined two cases of CPC. One is a 12-month-old boy, and the other is a 13-month-old boy. Both patients present lateral ventricular masses with extensive hydrocephalus. Histologically, both tumors show papillary growth in most area, and focal solid growth. The tumor cells show marked nuclear pleomorphism and frequent mitoses on squash and hematoxylin-eosin slides. Immunohistochemically, both tumors are positive for cytokeratin, vimentin, and S-100 protein; but they are negative for glial fibrillary acidic protein, -fetoprotein, and placental alkaline phosphatase. Both tumors show diffuse and strong positivity for p53. The MIB-1 labelling index is 23.6% and 15.82%, respectively. We report two cases of typical CPC, and we briefly discuss differential diagnosis with review of literatures.
Alkaline Phosphatase ; Brain ; Carcinoma ; Child ; Choroid Plexus Neoplasms ; Choroid Plexus* ; Choroid* ; Diagnosis ; Diagnosis, Differential ; Ependymoma ; Epithelium ; Glial Fibrillary Acidic Protein ; Humans ; Hydrocephalus ; Immunohistochemistry ; Infant ; Keratins ; Male ; Medulloblastoma ; Mitosis ; Neoplasms, Germ Cell and Embryonal ; Papilloma, Choroid Plexus ; S100 Proteins ; Vimentin

Cancer may be a disease of genes, arising from genetic damage of diverse sorts-recessive and dominant mutations, large rearrangement of DNA and gene translocation on chromosomes, all leading to distorisions of either the expression or biochemical function of genes. The search for these genetic damage in neoplastic cells now is the most important in cancer research. It has been found that the cancer relevant genes were located on the specific regions of chromosomes. To determine whether epidermal growth factor receptor(EGFR), P53 and bcr genes located in chromosomes 7, 17 and 22 are altered, we examined 12 neuroepithelial tumor with Southern blot analysis(five low grade astrocytoma, two high grade astrocytoma, two medulloblastoma, on oligodendroglioma, one ependymoma, one choroid plexus papilloma). The loss of heterozygosity(LOH) of EGFR gene was detected in two cases of medulloblastoma. The rearrangement of EGFR gene was detected in a case of ependymoma. The LOH of P53 gene was found in a case of choroid plexus papilloma and low grade astrocytoma. The rearrangement of P53 gene was founs id a case of oligodendroglioma. The LOH of bcr gene was observed in two cases of medulloblastoma and low grade astrocytoma. The rearrangement of bcr gene was observed in two cases of high grade astrocytoma. These results suggested that tumorigenesis and tumor development in the neuroepithelial tumor may invlove specific gene changes in chromosomes 7, 17 and 22.
Astrocytoma ; Blotting, Southern ; Carcinogenesis ; Choroid Plexus ; DNA ; Ependymoma ; Epidermal Growth Factor ; Genes, erbB-1 ; Genes, p53 ; Loss of Heterozygosity ; Medulloblastoma ; Neoplasms, Neuroepithelial* ; Oligodendroglioma ; Papilloma, Choroid Plexus

Intrathird ventricular tumors that mainly occupy the ventricle cavity without extending to the neighbouring structures are rare. These tumors are developed from the choroids plexus, tela, ependyma, subjacent neuroglia and embryonic cell rest. The authors experienced 11 cases of rare intrathird ventricular tumors during the past 10 years. During the same period, number of surgically proven brain tumors were 990 and intrathird ventricular tumors comprised 1.1%. These are two cases of choroids plexus papillomas, three craniopharyngiomas, two germ cell tumors, one meningioma, one glioependymal cyst, one ependymoma, one astrocytoma. Suprasellar craniopharyngiomas, thalamic gliomas, optic and hypothalamic gliomas were excluded. The age distribution was from 6 years old to 59 years old. The clinical manifestation was characteristic in that they usually had the sudden intermittent headache without specific localizing signs. Surgical approach to this area is by transcallosal or transcortical approach. Surgical total removal was quite feasible by either approach and outcome was rather favorable.
Age Distribution ; Astrocytoma ; Brain Neoplasms ; Child ; Choroid ; Craniopharyngioma ; Ependyma ; Ependymoma ; Glioma ; Headache ; Humans ; Meningioma ; Middle Aged ; Neoplasms, Germ Cell and Embryonal ; Neuroglia ; Optic Nerve Glioma ; Papilloma ; Papilloma, Choroid Plexus

Intrathird ventricular tumors that mainly occupy the ventricle cavity without extending to the neighbouring structures are rare. These tumors are developed from the choroids plexus, tela, ependyma, subjacent neuroglia and embryonic cell rest. The authors experienced 11 cases of rare intrathird ventricular tumors during the past 10 years. During the same period, number of surgically proven brain tumors were 990 and intrathird ventricular tumors comprised 1.1%. These are two cases of choroids plexus papillomas, three craniopharyngiomas, two germ cell tumors, one meningioma, one glioependymal cyst, one ependymoma, one astrocytoma. Suprasellar craniopharyngiomas, thalamic gliomas, optic and hypothalamic gliomas were excluded. The age distribution was from 6 years old to 59 years old. The clinical manifestation was characteristic in that they usually had the sudden intermittent headache without specific localizing signs. Surgical approach to this area is by transcallosal or transcortical approach. Surgical total removal was quite feasible by either approach and outcome was rather favorable.
Age Distribution ; Astrocytoma ; Brain Neoplasms ; Child ; Choroid ; Craniopharyngioma ; Ependyma ; Ependymoma ; Glioma ; Headache ; Humans ; Meningioma ; Middle Aged ; Neoplasms, Germ Cell and Embryonal ; Neuroglia ; Optic Nerve Glioma ; Papilloma ; Papilloma, Choroid Plexus

Focal ventricular dilatation of the temporal horn caused by an occlusion of the cerebrospinal fluid pathway at the atrium of the lateral ventricle is a form of non communicating hydrocephalus, and this condition is termed as "entrapment of the temporal horn". The choroid plexus is important central nervous system(CNS) structure, but it is often neglected in pathologic and clinical studies of intracranial diseases. Even though choroid plexitis is very rare, it may be occurred as the resultant of CNS infections and primary choroid plexitis can be associated with bacterial, viral, and parasitic etiologies. Some aspects of the neuroimaging findings of this infection mimick those of a intraventricular neoplasms. The most important neoplasms which should be differentiated, are choroid plexus papilloma and carcinoma. Wherem primary neoplasms of the choroid plexus are well known, but primary infections of the choroid plexus (such as choroid plexitis) are not commonly encountered. Pseudomonas stutzeri infections are especially rare as the causative organism of the choroid plexitis and often have serious underlying disease but generally respond well to treatment with antibiotics. We report a 65-year-old female patient with primary choroid plexitis due to Pseudomonas stutzeri and the findings of her brain computerized tomography and magnetic resonance imaging. In conclusion, our case revealed that choroid plexitis may result in ventricular entrapment and mimick intraventricular tumors. Although it is very rare, when a intraventricular mass was observed in imaging studies and combined with signs and symptoms suggesting CNS infection, choroid plexitis should be considered.
Aged ; Animals ; Anti-Bacterial Agents ; Brain ; Cerebral Ventricle Neoplasms ; Cerebrospinal Fluid ; Choroid Plexus ; Choroid* ; Dilatation ; Female ; Horns* ; Humans ; Hydrocephalus ; Lateral Ventricles* ; Magnetic Resonance Imaging ; Neuroimaging ; Papilloma, Choroid Plexus ; Pseudomonas stutzeri* ; Pseudomonas*

One to three percent of childhood brain tumors are choroid plexus tumors. Of these, 30-40% are considered to be choroid plexus carcinoma. We report one case of choroid plexus carcinoma without parenchymal invasion, which showed rapid dissemination along whole CSF pathway and developed postoperative hydrocephalus in spite of gross total resection.
Brain Neoplasms ; Choroid Plexus Neoplasms ; Choroid Plexus* ; Choroid* ; Hydrocephalus