Preoperative embolization of choroid plexus papilloma with Onyx via the anterior choroidal artery: technical note

Trivelato, Felipe Padovani; Manzato, Luciano Bambini; Rezende, Marco Túlio Salles; Barroso, Pedro; Faleiro, Rodrigo Moreira; Ulhôa, Alexandre Cordeiro

doi:10.1007/s00381-012-1928-0

Cited by 20 publications

(10 citation statements)

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“…Surgical removal is the treatment of choice, and gross total removal should be attempted in all cases. [ 3 7 12 15 25 30 34 42 ] As these tumors are highly vascular, exquisite care needs to be taken during surgery, especially in young children in whom these tumors are most commonly seen as few cases of mortality due to perioperative blood loss have been reported. [ 7 ] Blood loss needs to be contained by securing the main arterial feeder (usually a branch of a choroidal artery) early in the course of surgery followed by tumor coagulation and en bloc or piecemeal removal.…”

Section: Discussionmentioning

confidence: 99%

“…[ 12 20 21 41 ] Advances in catheter technology have made embolization of small caliber feeding vessels possible in the preoperative period and few such successful cases have been reported in literature, however, this mandates radiation and has additional risks such as vessel injury and stroke. [ 6 15 42 ] Recently, intraoperative usage of tranexamic acid has been reported in infants undergoing surgery for these tumors for reducing blood loss. [ 27 ] Management of hydrocephalus is an important aspect due to its ubiquitous accompaniment with these lesions seen in the majority of cases.…”

Section: Discussionmentioning

confidence: 99%

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Case series of choroid plexus papilloma in children at uncommon locations and review of the literature

Prasad¹,

Mahapatra²

2015

Surg Neurol Int

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Background:Choroid plexus papillomas (CPPs) comprise around 1% of intracranial neoplasms. The most common location is atrium of the lateral ventricle in children and fourth ventricle in adults. Other rare locations include third ventricle, cerebellopontine (CP) angle and cerebral parenchyma, with only a few cases reported. Authors report three cases of CPP at uncommon locations in pediatric patients. The rarity of these locations, diagnostic dilemma and management aspects are discussed along with an extensive review of the literature.Methods:Retrospective institutional data analysis of histopathologically confirmed pediatric CPPs from 2010 to 2014.Results:Authors noted three cases of CPP in children in uncommon locations-one each in the posterior third ventricle, fourth ventricle, and CP angle. All were males in the first decade. Two cases presented with features of obstructive hydrocephalus while the latter presented with compressive effects. Complete excision was achieved in two cases while subtotal removal was performed in one case (fourth ventricular) because of excess blood loss. Mean follow-up duration was 24.6 months (range 20–30 months). One case (of subtotal removal) had fair recovery while other two had excellent outcomes.Conclusions:Posterior third ventricle, fourth ventricle, and CP angle are uncommon locations for these tumors in children. Complete surgical removal is the treatment of choice and approach needs to be tailored according to the site and size of the lesion. Blood loss is a major concern in young children as they are highly vascular tumors. Complete removal leads to excellent long-term survival rates. Adjuvant treatment is not required.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Case series of choroid plexus papilloma in children at uncommon locations and review of the literature

Prasad¹,

Mahapatra²

2015

Surg Neurol Int

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“…Many materials can be used. The best embolization results are achieved using small or liquid agents that can penetrate the tumor bed and embolize the vessels at the capillary level, but these agents are also the most dangerous because they can damage normal structures 66 . Thus, caution must be taken when these embolic agents migrate.…”

Section: Brain Tumorsmentioning

confidence: 99%

“…Several agents can be used; for instance, in 1992, Oyama et al used microfibrillar collagen to embolize a 53-year-old female with a large meningioma in the right trigone 59 . Recently, superselective injection using Onyx (EV3, Irvine, CA) as the embolic agent has been utilized 66 . Moreover, recent advances in microcatheter and microwire technologies currently make these once complex lesions more amenable to endovascular therapy.…”

Section: Brain Tumorsmentioning

confidence: 99%

Clinical importance of the anterior choroidal artery: a review of the literature

Xu¹,

Zhao²,

Yu³

2018

Int. J. Med. Sci.

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The anterior choroidal artery (AChA) is a critical artery in brain physiology and function. The AChA is involved in many diseases, including aneurysm, brain infarct, Moyamoya disease (MMD), brain tumor, arteriovenous malformation (AVM), etc. The AChA is vulnerable to damage during the treatment of these diseases and is thus a very important vessel. However, a comprehensive systematic review of the importance of the AChA is currently lacking. In this study, we used the PUBMED database to perform a literature review of the AChA to increase our understanding of its role in neurophysiology. Although the AChA is a small thin artery, it supplies an extremely important region of the brain. The AChA consists of cisternal and plexal segments, and the point of entry into the choroidal plexus is known as the plexal point. During treatment for aneurysms, tumors, AVM or AVF, the AChA cisternal segments should be preserved as a pathway to prevent the infarction of the AChA target region in the brain. In MMD, a dilated AChA provides collateral flow for posterior circulation. In brain infarcts, rapid treatment is necessary to prevent brain damage. In Parkinson disease (PD), the role of the AChA is unclear. In trauma, the AChA can tear and result in intracranial hematoma. In addition, both chronic and non-chronic branch vessel occlusions in the AChA are clinically silent and should not deter aneurysm treatment with flow diversion. Based on the data available, the AChA is a highly essential vessel.

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“…There are some reports of pre-operative embolization of feeder artery, however this approach is challenging and have potential risks of vessel injury or stroke (25,32,33). Neoadjuvant chemotherapy can be considered as an alternative approach which reduces tumor size and vascularity and facilitates total resection (34).…”

Section: Managementmentioning

confidence: 99%

An extremely rare case of choroid plexus carcinoma in third ventricle of an infant – Case report and review of literature

Tavallaii

Keykhosravi

Rezaee

et al. 2020

Preprint

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Background: Choroid plexus tumors are rare intraventricular tumors. Most of these tumors are benign choroid plexus papillomas. Choroid plexus carcinoma is the most malignant choroid plexus tumor and comprise a small percentage of these tumors. Most common location of these tumors are lateral ventricle and fourth ventricle in pediatric and adult patients respectively. Rare locations such as third ventricle are reported in the literature with 55 reports of choroid plexus papilloma and just 3 cases of carcinoma located in third ventricle. Case description: we present an extremely rare case of choroid plexus carcinoma of third ventricle in a 9 months old boy which was resected successfully through transcortical-transforaminal approach along with a review of literature available around different aspects of these tumors.Conclusion: Choroid plexus carcinomas even in rare locations such as third ventricle can be effectively resected through transcortical-transforaminal approach, although post-operative subdural effusion can be a potential complication.

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Preoperative embolization of choroid plexus papilloma with Onyx via the anterior choroidal artery: technical note

Abstract: Embolization of choroid plexus tumors via anterior choroidal artery is potentially dangerous, but following a meticulous technique, it can be used as a safe and effective preoperative procedure.

Cited by 20 publications

References 10 publications

Case series of choroid plexus papilloma in children at uncommon locations and review of the literature

Case series of choroid plexus papilloma in children at uncommon locations and review of the literature

Clinical importance of the anterior choroidal artery: a review of the literature

An extremely rare case of choroid plexus carcinoma in third ventricle of an infant – Case report and review of literature

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