Case of the Week
Section Editors: Matylda Machnowska1 and Anvita Pauranik2
1University of Toronto, Toronto, Ontario, Canada
2BC Children's Hospital, University of British Columbia, Vancouver, British Columbia, Canada
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January 2, 2012
Choroid Plexus Papilloma of the 4th Ventricle
- Choroid plexus papillomas are rare benign tumors of the CNS that account for 0.4-0.6% of all brain tumors. They are usually confined to the ventricular system. The most common site of origin in pediatric age group is within the atria of the lateral ventricles, whereas the fourth ventricle is the most common site in adults.
- The most common presentation is with raised intracranial pressure as a consequence of cerebrospinal fluid (CSF) over-production or obstruction to the CSF pathway. Other presenting features include cerebellar dysfunction and cranial nerve involvement.
- Key Diagnostic Features: MRI demonstrates a cauliflower-like mass, iso to hypointense on T1WI, variably hyperintense on T2WI, and demonstrating intense enhancement following contrast administration. Flow-voids suggestive of high vascularity can be seen on the conventional T1WI and T2WI. CSF seeding can occur and should be evaluated.
- DDx: Choroid plexus carcinoma, Ependymoma, Metastasis, Meningioma
- Rx: Surgery
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