Choroid plexus papilloma: Difference between revisions

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{{Refimprove|date=August 2013}}
{{SI}}  
{{Infobox medical condition (new)
{{Infobox medical condition
| name            = Choroid plexus papilloma
| name            = Choroid plexus papilloma
| synonyms        = Papilloma of the choroid plexus
| image          = [[File:Plexuspapillom_Makroskopie.png|250px]]
| image          = Plexuspapillom Makroskopie.png
| caption        = Gross pathology of a choroid plexus papilloma
| caption        =  
| field          = [[Neurosurgery]], [[Oncology]]
| pronounce      =
| symptoms        = [[Headache]], [[nausea]], [[vomiting]], [[hydrocephalus]]
| field          = [[Neurosurgery]]
| complications  = [[Hydrocephalus]], [[increased intracranial pressure]]
| symptoms        =  
| onset          = Typically in [[children]]
| complications  =  
| duration        = Variable
| onset          =  
| duration        =  
| types          =  
| types          =  
| causes          =  
| causes          = Unknown
| risks          =  
| risks          =  
| diagnosis      =  
| diagnosis      = [[Magnetic resonance imaging|MRI]], [[Computed tomography|CT scan]], [[biopsy]]
| differential    =  
| differential    = [[Choroid plexus carcinoma]], [[meningioma]], [[ependymoma]]
| prevention      =  
| prevention      = None
| treatment      =  
| treatment      = [[Surgical resection]], [[ventriculoperitoneal shunt]]
| medication      =  
| medication      =  
| prognosis      =  
| prognosis      = Generally good with complete resection
| frequency      =  
| frequency      = Rare
| deaths          =
}}
}}
 
'''Choroid plexus papilloma''' is a rare, benign [[tumor]] that arises from the [[choroid plexus]] tissue in the [[ventricular system]] of the [[brain]]. This tumor is classified as a [[World Health Organization]] (WHO) grade I tumor, indicating its non-malignant nature. Despite being benign, it can cause significant clinical symptoms due to its location and the potential for [[cerebrospinal fluid]] (CSF) overproduction.
'''Choroid plexus papilloma''', also known as '''papilloma of the choroid plexus''', is a rare benign neuroepithelial intraventricular [[WHO Grades of CNS Tumors|WHO grade I]] lesion found in the [[choroid plexus]].<ref name="pmid10940770">{{cite journal |vauthors=McEvoy AW, Harding BN, Phipps KP |title=Management of choroid plexus tumours in children: 20 years experience at a single neurosurgical centre |journal=Pediatr Neurosurg |volume=32 |issue=4 |pages=192–9 |date=April 2000 |pmid=10940770 |doi= 10.1159/000028933|url=http://content.karger.com/produktedb/produkte.asp?typ=fulltext&file=pne32192|display-authors=etal}}</ref>  It leads to increased [[cerebrospinal fluid]] production, thus causing increased [[intracranial pressure]] and [[hydrocephalus]].<ref name="AdunkaBuchman2010">{{cite book|author1=Oliver Adunka|author2=Craig Buchman|title=Otology, Neurotology, and Lateral Skull Base Surgery: An Illustrated Handbook|url=https://books.google.com/books?id=2kv-Z-L5UUAC&pg=PT353|accessdate=12 August 2013|date=11 October 2010|publisher=Thieme|isbn=978-3-13-149621-8|pages=353–}}</ref>
== Pathophysiology ==
 
The choroid plexus is responsible for the production of CSF, which cushions the brain and spinal cord. A choroid plexus papilloma can lead to an overproduction of CSF, resulting in [[hydrocephalus]], a condition characterized by an accumulation of fluid in the brain. This can increase intracranial pressure and cause symptoms such as headaches, nausea, vomiting, and changes in mental status.
Choroid plexus papilloma occurs in the [[lateral ventricles]] of children and in the [[fourth ventricle]] of adults. This is unlike most other pediatric tumors and adult tumors, in which the locations of the tumors is reversed. In children, brain tumors are usually found in the [[infratentorial]] region and in adults, brain tumors are usually found in the [[supratentorial]] space. The relationship is reversed for choroid plexus papillomas.
== Clinical Presentation ==
 
Patients with choroid plexus papilloma may present with symptoms related to increased intracranial pressure. In infants, this can manifest as an increase in head size, irritability, and poor feeding. In older children and adults, symptoms may include headaches, nausea, vomiting, and visual disturbances. Seizures and focal neurological deficits can also occur depending on the tumor's location.
==Signs and symptoms==
== Diagnosis ==
Signs of the tumor resulting from increased [[intracranial pressure]] are present in 91% of patients, with [[vomiting]], [[homonymous hemianopia|homonymous visual field defects]] and [[headache]] being the most common symptoms.
Diagnosis of choroid plexus papilloma is typically made using imaging studies such as [[MRI]] or [[CT scan]], which can reveal a well-circumscribed mass within the ventricles. The tumor often appears as a lobulated mass with a cauliflower-like appearance. Histological examination following surgical resection confirms the diagnosis, showing papillary structures lined by a single layer of epithelial cells.
Other symptoms are ear ringing and dizziness.
== Treatment ==
 
The primary treatment for choroid plexus papilloma is surgical resection. Complete removal of the tumor often results in a cure, and symptoms related to hydrocephalus may resolve postoperatively. In cases where complete resection is not possible, additional treatments such as [[ventriculoperitoneal shunt]] placement to manage hydrocephalus may be necessary.
==Pathophysiology==
== Prognosis ==
The tumor is neuroectodermal in origin and similar in structure to a normal [[choroid plexus]]. They may be created by [[epithelial cell]]s of the [[choroid plexus]].
The prognosis for patients with choroid plexus papilloma is generally excellent following complete surgical resection. Recurrence is rare, and long-term outcomes are favorable. However, the presence of hydrocephalus and the need for shunt placement can affect quality of life and require ongoing management.
 
== See also ==
<gallery>
* [[Choroid plexus]]
Image:Choroid plexus papilloma micrograph.jpg|[[Micrograph]] of a choroid plexus papilloma. [[H&E stain]].
* [[Hydrocephalus]]
Image:Plexuspapillom Detail.jpg|Plexuspapillom Detail
* [[Brain tumor]]
Image:Plexuspapillom Overview.jpg|Plexuspapillom Overview
* [[Ventricular system]]
</gallery>
[[Category:Brain tumors]]
 
[[Category:Neuro-oncology]]
==Treatment==
{{stub}}
Choroid plexus papillomas are benign tumors that are usually cured by surgery; malignant progression has been rarely reported.
 
==Epidemiology==
Internationally tumors of the choroid plexus are rare, accounting for 0.4-0.6% of all intracranial neoplasms. It most commonly affects young children under the age of 5 with a mean patient age of 5.2 years.
 
==References==
{{reflist}}
 
== External links ==
{{Medical resources
|  DiseasesDB    = 
|  ICD10          = {{ICD10|C|71|5|c|69}}
|  ICD9          = {{ICD9|191.5}}
|  ICDO          = {{ICDO|9390|1}}
|  OMIM          = 
|  MedlinePlus    = 
|  eMedicineSubj  = article
|  eMedicineTopic = 250795
|  eMedicine_mult = {{eMedicine2|radio|171}}
|  MeshID        = D020288
}}
{{Commonscat-inline}}
* [http://rad.usuhs.edu/medpix/medpix.html?mode=image_finder&action=search&srchstr=choroid%20plexus%20papilloma&srch_type=all#top Choroid Plexus Papilloma] MRI, CT, and pathology images from MedPix
 
{{Central nervous system tumors}}
{{CNS diseases of the nervous system}}
 
[[Category:Brain tumor]]
{{dictionary-stub1}}
<gallery>
File:Plexuspapillom Makroskopie.png|Choroid plexus papilloma
File:Choroid plexus papilloma micrograph.jpg|Choroid plexus papilloma
File:Plexuspapillom Detail.jpg|Choroid plexus papilloma
File:Plexuspapillom Overview.jpg|Choroid plexus papilloma
</gallery>

Latest revision as of 00:39, 27 April 2025

Editor-In-Chief: Prab R Tumpati, MD
Obesity, Sleep & Internal medicine
Founder, WikiMD Wellnesspedia &
W8MD medical weight loss NYC and sleep center NYC

Choroid plexus papilloma
Synonyms N/A
Pronounce N/A
Specialty N/A
Symptoms Headache, nausea, vomiting, hydrocephalus
Complications Hydrocephalus, increased intracranial pressure
Onset Typically in children
Duration Variable
Types
Causes Unknown
Risks
Diagnosis MRI, CT scan, biopsy
Differential diagnosis Choroid plexus carcinoma, meningioma, ependymoma
Prevention None
Treatment Surgical resection, ventriculoperitoneal shunt
Medication
Prognosis Generally good with complete resection
Frequency Rare
Deaths N/A


Choroid plexus papilloma is a rare, benign tumor that arises from the choroid plexus tissue in the ventricular system of the brain. This tumor is classified as a World Health Organization (WHO) grade I tumor, indicating its non-malignant nature. Despite being benign, it can cause significant clinical symptoms due to its location and the potential for cerebrospinal fluid (CSF) overproduction.

Pathophysiology[edit]

The choroid plexus is responsible for the production of CSF, which cushions the brain and spinal cord. A choroid plexus papilloma can lead to an overproduction of CSF, resulting in hydrocephalus, a condition characterized by an accumulation of fluid in the brain. This can increase intracranial pressure and cause symptoms such as headaches, nausea, vomiting, and changes in mental status.

Clinical Presentation[edit]

Patients with choroid plexus papilloma may present with symptoms related to increased intracranial pressure. In infants, this can manifest as an increase in head size, irritability, and poor feeding. In older children and adults, symptoms may include headaches, nausea, vomiting, and visual disturbances. Seizures and focal neurological deficits can also occur depending on the tumor's location.

Diagnosis[edit]

Diagnosis of choroid plexus papilloma is typically made using imaging studies such as MRI or CT scan, which can reveal a well-circumscribed mass within the ventricles. The tumor often appears as a lobulated mass with a cauliflower-like appearance. Histological examination following surgical resection confirms the diagnosis, showing papillary structures lined by a single layer of epithelial cells.

Treatment[edit]

The primary treatment for choroid plexus papilloma is surgical resection. Complete removal of the tumor often results in a cure, and symptoms related to hydrocephalus may resolve postoperatively. In cases where complete resection is not possible, additional treatments such as ventriculoperitoneal shunt placement to manage hydrocephalus may be necessary.

Prognosis[edit]

The prognosis for patients with choroid plexus papilloma is generally excellent following complete surgical resection. Recurrence is rare, and long-term outcomes are favorable. However, the presence of hydrocephalus and the need for shunt placement can affect quality of life and require ongoing management.

See also[edit]

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