Clinical Pain

Korean Association of Pain Medicine (대한임상통증학회)
권호 표지
DOI QR코드

DOI QR Code

An Atypical Choroid Plexus Papilloma Initially Manifestating as Radicular Symptoms

방사성 증상이 초기 증상으로 나타난 비정형 맥락막 신경총 유두종

  • Lee, Cheol-Jae (Department of Physical Medicine and Rehabilitation, Sahmyook Medical Center) ;
  • Kim, Jun-Hyung (Department of Physical Medicine and Rehabilitation, Sahmyook Medical Center) ;
  • Kim, Yunhee (Department of Physical Medicine and Rehabilitation, Sahmyook Medical Center) ;
  • Lee, Jang-Bo (Department of Neurosurgery, Korea University College of Medicine) ;
  • Ryu, Byungju (Department of Physical Medicine and Rehabilitation, Sahmyook Medical Center)
  • 이철재 (삼육서울병원 재활의학과) ;
  • 김준형 (삼육서울병원 재활의학과) ;
  • 김윤희 (삼육서울병원 재활의학과) ;
  • 이장보 (고려대학교 의과대학 신경외과학교실) ;
  • 류병주 (삼육서울병원 재활의학과)
  • Received : 2020.10.24
  • Accepted : 2020.11.09
  • Published : 2021.06.30
⟨ Previous Next ⟩

Abstract

A 29-year-old woman had 1-month history of back pain radiating into lower extremities, motor weakness, and sensory abnormalities in both lower extremities. Contrast-enhanced spinal magnetic resonance imaging (MRI) revealed a homogeneously enhancing mass at the T12~L1 and several intradural enhancing nodular lesions at L2~S1. Tumor resection surgery was performed and following histological examination showed that the tumor satisfied the diagnostic criteria for atypical choroid plexus papilloma (CPP). To find primary tumor sites, contrast-enhanced brain MRI, whole spine MRI, and PET-CT were carried out and additional lesions were detected at the fourth ventricle, right cerebellum, and upper thoracic spinal cord. This is a very rare case of metastatic atypical CPP that involves brain, upper thoracic spinal cord, and cauda equina with initial manifestation of radicular symptoms without clinical signs of primary brain lesion.

Keywords

References

  1. Paulus W, Janisch W. Clinicopathologic correlations in epithelial choroid plexus neoplasms: a study of 52 cases. Acta Neuropathol 1990; 80: 635-641 https://doi.org/10.1007/BF00307632
  2. Kaptanglu E, Tun K, Celikmez RC, Ozen O, Taskin Y. Spinal drop metastasis of choroid plexus papilloma. J Clin Neurosci 2007; 14: 381-383 https://doi.org/10.1016/j.jocn.2005.12.017
  3. Boldorini R, Panzarasa G, Girardi P, Monga G. Primary choroid plexus papilloma of the sacral nerve roots: Case reoprt. J Neurosurg Spine 2009; 10: 51-53 https://doi.org/10.3171/2008.10.SPI08277
  4. Wrede B, Hasselblatt M, Peters O, Thall PF, Kutluk T, Moghrabi A, et al. Atypical choroid plexus papilloma: clinical experience in the CPT-SIOP-2000 study. J Neurooncol 2009; 95: 385-392
  5. Leblanc R, Bekhor S, Melanson D, Carpenter S. Diffuse craniospinal seeding from a benign fourth ventricle choroid plexus papilloma: Case report. J Neurosurg 1998; 88: 757-760 https://doi.org/10.3171/jns.1998.88.4.0757
  6. Abdulkader MM, Mansour NH, Van Gompel JJ, Bosh GA, Dropcho EJ, Bonnin JM, et al. Disseminated choroid plexus papillomas in adults: A case series and review of the literature. J Clin Neurosci 2016; 32: 148-154 https://doi.org/10.1016/j.jocn.2016.04.002
  7. Louis DN, Ohgaki H, Wiestier OD, Cavenee WK, Ellison DW, Branger DF, et al. WHO classification of tumours of the central nervous system, 4th ed. Lyon: International Agency for Research on Cancer; 2016. p. 123-129
  8. Dhillon RS, Wang YY, McKelvie PA, O'Brien B. Progression of choroid plexus papilloma. J Clin Neurosci 2013; 20: 1775-1778 https://doi.org/10.1016/j.jocn.2012.11.027
  9. McCall T, Binning M, Blumenthal DT, Jensen RL. Variations of disseminated choroid plexus papilloma: 2 case reports and a review of the literature. Surg Neurol 2006; 66: 62-67 https://doi.org/10.1016/j.surneu.2005.09.023
  10. Akil H, Coupe NJ, Singh J. Spinal deposits of a benign choroid plexus papilloma. J Clin Neurosci 2008; 15: 708-712 https://doi.org/10.1016/j.jocn.2007.05.026