J Korean Neurosurg Soc.  2016 Jan;59(1):58-61. 10.3340/jkns.2016.59.1.58.

Sellar-Suprasellar Extraventricular Choroid Plexus Papilloma : A Case Report and Review of the Literature

• Keskin F
• Erdi F
• Kaya B
• Toy H

• KMID: 2152919
• DOI: http://doi.org/10.3340/jkns.2016.59.1.58

Abstract

Choroid plexus papillomas (CPPs) are relatively rare neuroectodermal tumors that develop from choroid plexus epithelial cells and are usually restricted to the ventricles. Extraventricular CPPs are very unusual and can be difficult to diagnose and treat. A 50-year-old male patient was admitted to our clinic complaining of headache and visual deterioration. Neurological examination found no abnormalities except decreased light perception and secondary optic atrophy in the left eye. Endocrine testing revealed normal levels of hormones produced by the pituitary and target glands. Magnetic resonance imaging of the brain revealed a huge regular-shaped lesion in the sellar-suprasellar region occupying the sella turcica and extending into the suprasellar cistern and planum sphenoidale. The lesion was completely excised by microsurgery via an ordinary left-sided pterional approach. Histopathology identified the lesion as a choroid plexus papilloma. Following the case report, literature on the origin, differential diagnosis, and treatment of this rare tumor is reviewed.

Keyword

Choroid plexus papilloma; Extraventricular; Sellar-suprasellar; Magnetic resonance imaging; Pathology

MeSH Terms

Brain
Choroid Plexus*
Choroid*
Diagnosis, Differential
Epithelial Cells
Headache
Humans
Magnetic Resonance Imaging
Male
Microsurgery
Middle Aged
Neuroectodermal Tumors
Neurologic Examination
Optic Atrophy
Papilloma, Choroid Plexus*
Pathology
Sella Turcica
Temazepam
Temazepam

Figure

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  Fig. 1 Radiological findings. A : T1-weighted axial MRI reveals a hypointense regular-shaped cystic lesion at the ventricular border. B : Contrast-enhanced T1-weighted coronal MRI reveals that the lesion compresses the optic chiasma and elevates the third ventricle and identifies the contrast-enhanced solid hyperintense nodule at the right floor of the lesion, just above the suprasellar internal carotid artery. C : Hyperintense cystic lesion on T2-weighted axial MRI. D : Tumoral invasion of the planum sphenoidale, whole sellar area, and suprasellar cistern.

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  Fig. 2 Histology reveals the tumor's papillary structure with one or more layers of columnar epithelial cells around a fibrovascular core (H&E, ×40).

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  Fig. 3 Micrograph of immunostained section shows positive expression of pancytokeratin (×10).

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  Fig. 4 T1-weighted contrast enhanced axial (A) and T2-weighted sagittal (B) postoperative MRI show total excision of the tumor.

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  Fig. 5 Intraoperative image. A : The cystic component of the tumor (white arrow). B : Yellowish tumoral nodule (white arrow) after opening the cystic component.

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