Brain Tumor Res Treat.  2022 Oct;10(4):265-269. 10.14791/btrt.2022.0025.

Meningioma Originating From Choroid Plexus of Foramen of Luschka: A Rare Case Report and Tip of Differential Diagnosis

• Lee YJ
• Kim BS
• Kim YJ
• Lee KH
• Jung S

• KMID: 2534725
• DOI: http://doi.org/10.14791/btrt.2022.0025

Abstract

Meningiomas are the most common benign brain tumors, and most of them originate from the dura mater. However, in some cases, they can originate from the choroid plexus, and they are rarely found in the posterior cranial fossa. A 63-year-old female patient presented with dizziness and swallowing difficulty and was found to have a homogeneously enhancing mass in the right posterior cranial fossa. Mass removal was performed through retrosigmoid suboccipital craniotomy, and the mass was confirmed to originate from the choroid plexus. The pathological diagnosis was meningothelial meningioma. The patient had temporary swallowing difficulty but recovered without any neurological sequelae. We report a rare case of a lower cerebellopontine angle meningioma without dural attachment originating from the choroid plexus of the foramen of Luschka.

Keyword

Foramen of Luschka; Choroid plexus; Meningioma

Figure

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  Fig. 1 Preoperative brain imaging. A: Initial brain CT revealing a hyperdense mass in the right posterior cranial fossa (right cerebellopontine angle and cerebellomedullary cistern). B and C: Iso-/hypointense signal mass in T1-weighted and iso-/hyperintense signal mass in T2-weighted images. D-F: Brain MRI with gadolinium enhancement revealing a homogeneously enhancing mass and mass effect on the 4th ventricle without definitive hydrocephalus.

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  Fig. 2 Intraoperative findings. A: Mass of a large lower cerebellopontine angle region without dural attachment. B: 7th & 8th cranial nerves (yellow arrow) located in the cranial part and lower cranial nerves (9th & 10th) identified above the mass (black arrow). C: Mass originating from the choroid plexus of the foramen of Luschka. D: 4th ventricle lateral part (blue arrow) after mass removal and coagulation of the origin site.

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  Fig. 3 Histopathologic features. A: Meningothelial pattern of the tumor with moderate hypercellularity after hematoxylin-eosin (H&E) staining. The choroid plexus was observed near the tumor (yellow arrow). B: Normal choroid plexus invaded by tumor cells.

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  Fig. 4 CT image of the choroid plexus-originated meningioma. A: Choroid plexus on the contralateral side (red arrow). B: The choroid plexus was mixed with the mass on the tumor side (red arrow).

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