Efficacy of Multi-staged Surgery and Adjuvant Chemotherapy for Successful Treatment of Atypical Choroid Plexus Papilloma in an Infant  -Case Report-

Takahashi, Mamoru; Yamamoto, Junkoh; Aoyama, Yuichi; Soejima, Yositeru; Akiba, Daisuke; Nishizawa, Shigeru

doi:10.2176/nmc.49.484

Cited by 11 publications

(4 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In their report on an atypical choroid plexus papilloma, Takahashi and colleagues suggested that the exceptionally vascular nature of the tumor described ultimately led to their decision to stage surgery. 14 Similar reports in the literature describe instances in which signi cant vascularity of intra-axial tumors has led to the decision to pursue a staged surgery intraoperatively. Kumabe et al reported a case in which multi-stage surgery separating debulking and subcortical mapping was used in a case of anaplastic astrocytoma, and gross total resection without neurological de cit was achieved.…”

Section: Discussionmentioning

confidence: 73%

See 1 more Smart Citation

Staged Open Cranial Surgery for Primary Intra-axial Neoplasms: A Systematic Review

Bui¹,

Brown²,

Gendreau³

et al. 2023

Preprint

View full text Add to dashboard Cite

Background Staged surgery for skull base lesions has been utilized to facilitate maximal safe resection and optimize outcomes while minimizing morbidity and complications. Conversely, staged surgery for primary intraparenchymal neoplasms is less commonly performed and has not been reported as extensively within the literature. As such, we performed a systematic review to examine the unique surgical indications for staging, timing between stages, specific surgical approaches employed, and postoperative complications of staged surgery for primary intra-axial neoplasms. Methods A literature search was conducted in August 2021 using PubMed, Web of Science, and Cochrane databases using the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) recommendations. Titles and abstracts were evaluated independently by two authors, after which articles were selected for final analysis based on application of strict inclusion criteria during full text screen. Each included article was then qualitatively assessed and relevant variables – including operative approaches, timing, and outcomes – were extracted for synthesis. Results Of 115 results, 7 articles were included for final analysis and consisted of 17 pediatric and 4 adult patients. Staged approaches were more commonly utilized in the pediatric patient population for resection of astrocytoma and glioma. Pediatric patients had a timing of surgeries ranging from 5–10 days between operations, compared to 18 days-4 months in adult patients. Complications in pediatric patients were most commonly hemiparesis, hydrocephalus, CN VI and VII palsies, truncal ataxia, and cerebellar mutism, while complications in adult patients included language and abstract thinking deficits, respiratory failure, and motor weakness. Conclusion This study reports the first comprehensive review of staged surgical procedures for primary, intra-axial cranial neoplasms. There exists a large degree of heterogeneity in complications resulting from staged surgeries for intra-axial neoplasms, which are similar to complications associated with single-stage surgery for intraparenchymal lesions as well as multi-stage surgeries for skull base lesions.

show abstract

Section: Discussionmentioning

confidence: 73%

“…Finally, 7 papers were selected (Table 1) and included for further analysis. [14][15][16][17][18][19][20][21][22][23] Types of papers included 3 case series, 3 case reports, and 1 technical note (Table 1). The study publication dates ranged from 1998-2019.…”

Section: Database Searchmentioning

confidence: 99%

Staged Open Cranial Surgery for Primary Intra-axial Neoplasms: A Systematic Review

Bui¹,

Brown²,

Gendreau³

et al. 2023

Preprint

View full text Add to dashboard Cite

show abstract

“…As stated earlier, there is no paper investigating treatment options for atypical CPP in infants. Authors in one of the case reports have in fact suggested that atypical CPP should be considered as CPC and treated the patient with chemotherapy [32]. …”

Section: Discussionmentioning

confidence: 99%

Brain Tumors of Infancy - An Institutional Experience and Review of the Literature

2013

View full text Add to dashboard Cite

Introduction: Brain tumors in infants are rare and form a distinct subgroup of pediatric brain tumors. These tumors differ from tumors in older children with respect to histology and management and tend to have a poorer outcome. Methods: We analyzed 31 consecutive cases of brain tumors in infancy managed in our institute in the last 15 years and reviewed the published literature since 1990. Results: Only 2 of these patients had congenital tumors. Choroid plexus tumors were the most common histological subtype, followed by medulloblastoma; 62% of patients underwent a gross total or near-total excision of the tumor with 1 perioperative mortality; 68% of patients had a good outcome. Conclusion: Choroid plexus tumors were the most common histological type. Safe resection should be the goal of surgery. Surgeries for tumors in this age group were associated with lower rates of total excision and higher morbidity. Low-grade lesions as expected are associated with longer survival; however, long-term outcomes are far from satisfactory.

show abstract

“…The use of neoadjuvant chemotherapy in CPC has been reported as an approach that leads to a decrease in blood loss in patients undergoing surgery [ 7 ]. Preoperative embolization, albeit limited to a small number of patients, has been attempted since the end of the 90s, with encouraging results in terms of reducing blood loss, which, in turn, reduces morbidity and mortality and increases the likelihood of total resection ( Supplementary Table S1 ) [ 4 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 ]. However, the small and tortuous vasculature of small children, and the typical involvement of eloquent arteries, represent a significant hindrance.…”

Section: Introductionmentioning

confidence: 99%

Preoperative Devascularization of Choroid Plexus Tumors: Specific Issues about Anatomy and Embolization Technique

et al. 2021

View full text Add to dashboard Cite

(1) Background: Surgical treatment of choroid plexus tumors is challenging, burdened by a notable risk of bleeding. Neoadjuvant chemotherapy and preoperative embolization have been attempted, with encouraging results; however, the consensus on these procedures is lacking. (2) Methods: We present a case of a 10-month-old girl who underwent preoperative embolization of a hemorrhagic choroid plexus carcinoma of the lateral ventricle via the anterior choroidal artery, followed by total resection. (3) Results: The endovascular procedure was successfully completed, despite the rectification of the anterior choroidal artery associated with the absence of flow proximal to the plexal point. Minimal bleeding was observed during resection and the patient remained neurologically intact. (4) Conclusions: The time from entrance to exit in the anterior choroidal artery should be monitored and regarded as a potential ‘occlusion time’ in this specific group of patients. Nevertheless, our case supports the feasibility and effectiveness of preoperative embolization of a choroid plexus carcinoma of the lateral ventricle via the anterior choroidal artery, without complications. Furthermore, we suggest the use of a fast-embolic agent, such as N-butyl cyanoacrylate glue, as the preferred agent for this specific pathology and patient population.

show abstract

Efficacy of Multi-staged Surgery and Adjuvant Chemotherapy for Successful Treatment of Atypical Choroid Plexus Papilloma in an Infant -Case Report-

Cited by 11 publications

References 16 publications

Staged Open Cranial Surgery for Primary Intra-axial Neoplasms: A Systematic Review

Staged Open Cranial Surgery for Primary Intra-axial Neoplasms: A Systematic Review

Brain Tumors of Infancy - An Institutional Experience and Review of the Literature

Preoperative Devascularization of Choroid Plexus Tumors: Specific Issues about Anatomy and Embolization Technique

Contact Info

Product

Resources

About