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Case Reports
. 2018 Jul 5:9:131.
doi: 10.4103/sni.sni_434_17. eCollection 2018.

Rapid malignant progression of an intraparenchymal choroid plexus papillomas

Luca Ruggeri  1 , Nicola Alberio  1 , Raffaele Alessandrello  1 , Giovanni Cinquemani  1 , Cesare Gambadoro  1 , Rita Lipani  1 , Rosario Maugeri  1 , Francesco Nobile  1 , Domenico Gerardo Iacopino  2 , Giovanni Urrico  3 , Roberto Battaglia  1
Affiliations
Case Reports

Rapid malignant progression of an intraparenchymal choroid plexus papillomas

Luca Ruggeri et al. Surg Neurol Int. .

Abstract

Background: Choroid plexus tumors (CPTs) are rare neoplasms accounting for only 0.3-0.6% of all brain tumors in adults and 2-5% in children. The World Health Organization (WHO) classification describes three histological grades: grade I is choroid plexus papilloma (CPP), grade II is atypical papilloma, and grade III is the malignant form of carcinoma. In adults, CPTs rarely have a supratentorial localization.

Case description: Here we report a very rare case of an intraparenchymal parietal CPP with a rapid histological transition from grade I to grade III WHO in a 67-year-old man, in <7 months.

Conclusion: Because of the rarity of these oncotypes, descriptions of each new case are useful, mostly to consider this diagnostic entity in extraventricular brain tumors of adults, despite an unusual location.

Keywords: Choroid plexus atypical papilloma; World Health Organization classification; choroid plexus carcinoma; choroid plexus papillomas; malignant progression.

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Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
First preoperative MRI shows a cystic plexus papilloma in the left parietal region. An enhanced ring can be visualized after gadolinium. Histological diagnosis revealed a CPP grade I WHO
Figure 2
Figure 2
Post operative CT scan showed the partial removal of the extra ventricular cystic lesion
Figure 3
Figure 3
A new MRI, after 7 months, showed a new cystic lesion in the cerebellar vermis with an eccentric nodule, in the temporal lobe and a recurrent multiloculated lesion in the left parietal region. Histological diagnosis was CPC grade III WHO
Figure 4
Figure 4
(a) Photomicrograph showing benign features of the CPP [hematoxylin and eosin (H and E) original magnification ×200] in the sample of the first surgical procedure. (b) Photomicrograph showing frank signs of malignancy of CPC (H and E original magnification ×100) in the sample of the second surgical procedure. (c) Demonstrates a representative area of the neoplasia with a high mitotic index (Ki-67 Ab, original magnification ×100)
See this image and copyright information in PMC

References

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