Cystic choroid plexus papilloma in the cavum septum pellucidum

Case report

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A choroid plexus papilloma is a rare CNS neoplasm arising from the neuroepithelial lining of the choroid plexus. A third ventricular location of a choroid plexus papilloma is rare compared with the more common sites in the lateral and fourth ventricles. Cystic choroid plexus papilloma represents an infrequent subtype that may present diagnostic ambiguity. The authors present a case of cystic choroid plexus papilloma within a cavum septum pellucidum that radiographically mimicked neurocysticercosis.

Article Information

Address correspondence to: Stephen P. Kalhorn, M.D., Department of Neurosurgery, NYU Langone Medical Center, 462 First Avenue, Bellevue Hospital, Room 7S4, New York, New York 10016. email: stephen.kalhorn@nyumc.org.

© AANS, except where prohibited by US copyright law.

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Figures

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    Preoperative T1-weighted MR image with Gd enhancement showing cystic structure within cavum septum pellucidum with an associated enhancing nodule.

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    Postoperative T1-weighted MR image with Gd enhancement showing resection of previously observed lesion.

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    Comparison of photomicrographs from our case (upper) and a normal choroid plexus (lower). Upper: Image demonstrating a cystic structure with a fibrous nodule and dilated, thin-walled vascular channels. The inner lining of a cyst shows complex papillary projections with morphological features, and an immunohistochemical profile consistent with choroid plexus papilloma. Lower: Image of a normal choroid plexus from an unrelated autopsy case provided for comparison. This sample demonstrates low cuboidal, uniform epithelium without crowding, overlapping, or atypia of the nuclei. There are “cobblestoned” or “hobnailed” surfaces. H & E, original magnification × 4.

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    Photomicrograph of the choroid plexus papilloma in this case showing delicate fibrovascular connective tissue fronds covered by columnar epithelium, with disorganization, crowding, overlapping, and atypia of the nuclei. There are increased nuclear-to-cytoplasmic ratios and flat, rather than “cobblestoned,” surfaces. H & E, original magnification × 20.

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