Posterior fossa choroid plexus papilloma with focal ependymal differentiation in an adult patient: A case report and literature review

Abstract

Choroid plexus papillomas (CPPs) are rare neoplasms classified as World Health Organization grade I tumors. CPPs containing other tissues have occasionally been documented in the literature. However, few of these previous reports have provided clinical and radiological information. We herein report a case of a posterior fossa CPP with focal ependymal differentiation in a 42-year-old woman who presented with a 6-month history of progressive headache. Preoperative radiological images showed a hypervascular tumor protruding into the left foramen of Luschka with perilesional edema. Gross total resection of the tumor was performed. Histopathological examination revealed that the tumor was composed of papillary structures. Immunohistochemical staining of glial fibrillary acidic protein was focally positive around the capillaries, which was suggestive of “perivascular pseudorosette” formation. Our case showed similar imaging appearances as those of CPP; thus, it seems difficult to distinguish CPP with versus without ependymal differentiation by clinical and radiological features alone. The clinical significance and pathogenesis of ependymal differentiation in CPP remain unclear, and further case reports are required.

Diagnosis of choroid plexus papilloma: Current perspectives and future directions

“…The patient may experience palsies of cranial nerves III and VI, visual disturbance, headache, nausea, balance problems, and drowsiness. 15 , 16 Some patients present symptoms such as apathy, dysthymia, dysdiadochokinesis, ataxia, speechlessness, subarachnoid hemorrhage, and altered mental status. 2 , 3 Although these clinical manifestations may advance to more severe conditions, such as blindness, none have diagnostic significance on their own.…”

Foramen magnum papilloma case report and review of the literature

“…Matsushita S et al [7] 42 female Symms NP et al [9] 61 male 4 th ventricle and foramen magnum Benign CPP Midline suboccipital and c1 partial laminectomy Total None…”

“…In adults, a CPP is usually located inside the fourth ventricle. While extraventricular locations are rare, some CPPs arise in the foramen of Luschka and extend to the extraventricular area [3,4,5,6,7] . A rare case of multiple spinal drop metastases from CPP of the posterior fossa has also been published [8] .…”