Obstructive hydrocephalus due to choroid plexus carcinoma of third ventricle in pediatric: A rare case report

Abstract

Choroid plexus carcinoma (CPC) is an uncommon tumor that accounts for less than 1% of all pediatric brain tumors. CPC usually originates in the lateral ventricle, followed by the fourth ventricle; the incidence in the third ventricle is only 5% of all CPC cases (children and adults). We report an extremely rare tumor arising from the choroid plexus of the third ventricle in a 6-year-old child with progressive headache, macrocephaly, left hemiparesis, and sunset eyes. The imaging found a well-defined, lobulated mass with strong enhancement in the posterior part of the third ventricle, resulting in obstructive hydrocephalus. The patient underwent an endoscopic biopsy and histopathological examination, which resulted in choroid plexus carcinoma.

Keywords: Choroid plexus carcinoma; Choroid plexus of the third ventricle; Obstructive hydrocephalus; Pediatric brain tumor.

Fig. 1

(A-C) Axial-coronal-sagittal NECT head and (D-F) CECT head showed a solid mass (yellow arrow) arising in the posterior third ventricle that obstructed the cerebral aqueduct and causing hydrocephalus.

Fig. 2

The MR Imaging showed a mass (yellow arrow) in third ventricle with hypointense signal on T1W1 (A), slight hyperintense signal on T2W1 (B), no supression on T2-FLAIR (C) and subdural hygroma (blue arrow).

Fig. 3

The SWI sequence (A) showed multiple signal loss (yellow arrow) explaining the hemorrhage and a heterogenous enhancement in post contrast (B) (blue arrow).

Fig. 4

The tumor (yellow arrow) showed restricted diffusion in DWI (A)-ADC (B) with ROI taken in the solid part of the mass in ADC map revealed mean ADC value 978 × 10⁻⁶ mm²/s.

Fig. 5

Histopathological examination showed tumor component in H-E stain; original magnification x100 (A) and original magnification x200 (B), both described hypercelullarity, nuclear pleomorphism, large cell with bizzare nucleus, mytotic activity, and hemorrhage.