Symptomatic xanthogranuloma of the choroid plexus of the third ventricle. A new case with ultrastructural study

Razavi-Encha, F; Gray, Françoise; Gaston, André; Gherardi, R; Caron, John P.; Poirier, Jean‐Paul

doi:10.1016/0090-3019(87)90157-1

Cited by 21 publications

(10 citation statements)

References 11 publications

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“…Fifteen cases of XG of the lateral ventricles have been reported and the most frequent localization was the glomus of the choroid plexus. Among the sixteen cases of XG located in the third ventricle reported up to date 1,6,8,[10][11][12][13][14][15]17,18,20 only four were studied with MRI 17,18,20 . XG of the fourth ventricle are exceptional 19 .…”

Section: Discussionmentioning

confidence: 99%

Xanthogranuloma of the choroid plexus of the third ventricle: case report and literature review

et al. 2005

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ResumenEl xantogranuloma del plexo coroideo es un tumor benigno de etiología desconocida que raramente produce síntomas. Su comportamiento en los estudios de resonancia magnética se ha descrito en pocas ocasiones y no está bien definido. Presentamos un nuevo caso de xantogranuloma del tercer ventriculo con caraterísti-cas atípicas en los estudios de CT y RM craneal en un paciente de 47 años y una clínica de 2 meses de evolución de alteración de la marcha y deterioro cognitivo. Igualmente, se revisa la literatura existente respecto a la presentación clínica y radiológica de estos tumores.PALABRAS CLAVE: Xantogranuloma. Tumor de tercer ventrículo. RM Introduction XG are benign tumours typically composed of large foam-filled cells with clusters of lymphocytes and macrophages associated to cholesterol clefts. XG rarely cause neurological dysfunction 3,13,15 . With few exceptions, they constitute incidental autopsy findings almost always restricted to the choroid plexus of the lateral ventricles 21 . Obstruction of the ventricular system has been reported infrequently. Etiology is still debatable 17 . We report a new case of symptomatic XG of the third ventricle studied with CT and MRI and showing some particular histopathological and neuroradiological features. Case reportA 47-year-old man was admitted with a 2-month history of gait instability and urinary disturbances, consisting in occasional loss of sphincterian control and short-term memory deficits. The symptoms had developed insidiously and the patient did not suffer headache, vomiting or loss of visual acuity.Physical and routine laboratory examinations, including serum cholesterol determinations, were normal. Neurological examination revealed disturbance of recent memory and cognitive impairment. Fundoscopy was normal. He scored 24/30 on minimental test. Short stepped gait and intentional tremor were also observed.Cranial CT scan showed a 2x2x1 cm oval shaped lesion located in area of the third ventricle obstructing the foramina of Monro and causing biventricular hydrocephalus. The lesion was heterogeneous appearing partly hypodense and hyperdense, with hyperdense areas corresponding to calcification. Following contrast injection the lesion showed partial enhancement. There was associated edema in the basal ganglia of the left cerebral hemisphere ( Figure 1).Cranial MRI revealed the lesion in the region of third ventricle and hypothalamic area. It was located mainly extraventricularly, spreading between the fornices, oc- cluding both foramina of Monro and causing bilateral hydrocephalus. It was heterogeneous in appearance being isointense in pT1 sequences and hyperintense in pT2 images, showing haemosiderin deposits and calcification. Important hyperintensity extending into the left basal ganglia region suggestive of edema was also observed. Following gadolinium administration it showed partial enhancement ( Figure 2).The patient was operated through a transcallosal approach. The left foramen of Monro appeared deformated by a brown yellowish subependymal l...

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Section: Discussionmentioning

confidence: 99%

Xanthogranuloma of the choroid plexus of the third ventricle: case report and literature review

et al. 2005

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“…The association between XG and choroid plexus has been stated in several case reports, being the most common origin point for XG masses in CNS. [9][10][11][12] The most frequent localization of XG in CNS is in the trigon of the lateral ventricle, a less common location being the third ventricle [13,14].…”

Section: Discussionmentioning

confidence: 99%

“…Some authors proposed a tissue reaction to hemorrhage, others suggested a disturbance in lipids metabolism found in familial hypercholesterolemia and proliferation of different type of cells, while other authors like Wolf and Ayres described the "foamy cells" derived from arachnoid cells in the choroid stroma and proliferation of epithelial cells of the choroid plexus [16]. Razavi-Encha studied intraventricular lesions with electronic microscopy and noticed some leptomeningeal cells at the origin of xanthogranulomas [9].The epithelium of the choroid plexus presents cellular stratification and height reduction as they age, some of them becoming squamous. They may desquamate and increase in size becoming foamy by gathering intracytoplasmatic lipids P. Miranda et al analysed published cases until 2005 and noted fifteen cases of lateral ventricle choroid plexus xanthogranulomas and sixteen cases localized in the third ventricle, described histopathologic and radiologic findings in third ventricle masses [8].…”

Section: Discussionmentioning

confidence: 99%

Case Presentation: Unusual Association Between Possible Bilateral Intraventricular Xanthogranulomas, Postero-inferior Cerebellar Artery Aneurysm and Thrombophilia

Andone¹,

Romaniuc²,

Bajkó

et al. 2018

Acta Medica Marisiensis

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Introduction: Xanthogranulomas are rare, benign, usually asymptomatic, cutaneous tumors most frequently seen in children (juvenile xanthogranulomas). Some lesions can be found accidentally at randomly performed cerebral computer tomography (CT) or magnetic resonance imaging (MRI) or even on autopsy.Case report: We present the case of a 44 year-old woman, known with a thrombophilic disorder (PAI-1 gene mutation, MTHFR C677T and A1298C) on chronic anticoagulant treatment. The onset of symptoms was in 2010, when she presented paresthesia and lower limbs weakness. Two years later the patient presents with severe intermittent headache and left hemicrania and a cerebral angio-MRI is performed showing a left postero-inferior cerebellar artery aneurysm and two choroid plexus intraventricular masses in the lateral ventricles. The patient developed a new symptom, dysarthria in 2014 and in 2015 has multiple episodes of loss of consciousness, interpreted as epileptic seizures. Routine blood tests were within normal range, except for a high cholesterol level. The patient was tested for autoimmune, infectious, endocrine and metabolic diseases that were negative. Surgical treatment and biopsy from the lesion was proposed, however the patient refused both procedures.Conclusions: There is an association between xanthogranulomas localization and the choroid plexus, the most frequent CNS origin being in the trigon of the lateral ventricle. Our case does not resemble with any other case published, mostly because the unusual presentation, symptomatology and the association between xanthogranulomas, thrombophilia and postero-inferior cerebellar artery aneurysm which were never reported before in other cases of xanthogranulomas from the literature.

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“…Among the sixteen cases of XG located in the third ventricle reported up to date 1,6,8,[10][11][12][13][14][15]17,18,20 only four were studied with MRI 17,18,20 . XG of the fourth ventricle are exceptional 19 .…”

Section: Discussionmentioning

confidence: 99%

Xanthogranuloma of the choroid plexus of the third ventricle: case report and literature review

Miranda¹,

Lobato²,

Ricoy³

et al. 2005

Neurocirugía

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ResumenEl xantogranuloma del plexo coroideo es un tumor benigno de etiología desconocida que raramente produce síntomas. Su comportamiento en los estudios de resonancia magnética se ha descrito en pocas ocasiones y no está bien definido. Presentamos un nuevo caso de xantogranuloma del tercer ventriculo con caraterísti-cas atípicas en los estudios de CT y RM craneal en un paciente de 47 años y una clínica de 2 meses de evolución de alteración de la marcha y deterioro cognitivo. Igualmente, se revisa la literatura existente respecto a la presentación clínica y radiológica de estos tumores. . We report a new case of symptomatic XG of the third ventricle studied with CT and MRI and showing some particular histopathological and neuroradiological features. Case reportA 47-year-old man was admitted with a 2-month history of gait instability and urinary disturbances, consisting in occasional loss of sphincterian control and short-term memory deficits. The symptoms had developed insidiously and the patient did not suffer headache, vomiting or loss of visual acuity.Physical and routine laboratory examinations, including serum cholesterol determinations, were normal. Neurological examination revealed disturbance of recent memory and cognitive impairment. Fundoscopy was normal. He scored 24/30 on minimental test. Short stepped gait and intentional tremor were also observed.Cranial CT scan showed a 2x2x1 cm oval shaped lesion located in area of the third ventricle obstructing the foramina of Monro and causing biventricular hydrocephalus. The lesion was heterogeneous appearing partly hypodense and hyperdense, with hyperdense areas corresponding to calcification. Following contrast injection the lesion showed partial enhancement. There was associated edema in the basal ganglia of the left cerebral hemisphere ( Figure 1).Cranial MRI revealed the lesion in the region of third ventricle and hypothalamic area. It was located mainly extraventricularly, spreading between the fornices, oc- cluding both foramina of Monro and causing bilateral hydrocephalus. It was heterogeneous in appearance being isointense in pT1 sequences and hyperintense in pT2 images, showing haemosiderin deposits and calcification. Important hyperintensity extending into the left basal ganglia region suggestive of edema was also observed. Following gadolinium administration it showed partial enhancement ( Figure 2).The patient was operated through a transcallosal approach. The left foramen of Monro appeared deformated by a brown yellowish subependymal lesion adhered to the body of the left fornix. Total excision preserving both fornices was achieved. Histopathological examination revealed a lesion composed of foamy cells in relation to vascular lines corresponding to choroids plexus showing changes secondary to haemorrhage and fibrosis which would explain the absence of the typical epithelial covering of the choroid plexus. The histological diagnosis was xanthogranuloma ( Figure 3).Postoperative MRI control showed disappearance of perilesional edema and mass ef...

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Symptomatic xanthogranuloma of the choroid plexus of the third ventricle. A new case with ultrastructural study

Cited by 21 publications

References 11 publications

Xanthogranuloma of the choroid plexus of the third ventricle: case report and literature review

Xanthogranuloma of the choroid plexus of the third ventricle: case report and literature review

Case Presentation: Unusual Association Between Possible Bilateral Intraventricular Xanthogranulomas, Postero-inferior Cerebellar Artery Aneurysm and Thrombophilia

Xanthogranuloma of the choroid plexus of the third ventricle: case report and literature review

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