Fujio Shingo, Hirano Hirofumi, Kawano Hiroto, Hanaya Ryosuke, Oyoshi Tatsuki, Niiro Masaki, Arita Kazunori
Department of Neurosurgery, Graduate School of Medical and Dental Sciences, Kagoshima University, 8-35-1 Sakuragaoka, Kagoshima 890-8520, Japan.
No Shinkei Geka. 2010 Feb;38(2):149-55.
Choroid plexus papillomas are rare; they comprise less than 1% of all intracranial tumors. In children, most of these neoplasms arise in the lateral ventricle while in adults they are primarily located in the fourth ventricle. We report 3 children with choroid plexus papilloma in the fourth ventricle; they were one 5-month-old girl and 2 boys aged 8-and 15-years. The baby girl presented with macrocephaly and signs of raised intracranial pressure, the 2 boys exhibited cerebellar signs. On magnetic resonance imaging (MRI) the tumors were well-enhanced with a cauliflower-like contour and hydrocephalus. In one case, diffusion weighted images (DWIs) showed an isointense tumor signal clearly different from the well-known hyperintensity of medulloblastomas, Via suboccipital craniotomy we succeeded in the total or subtotal surgical resection of these tumors and there were no sequela. None of the tumors have recurred in the intervening 2-9 years. In conclusion, choroid plexus papilloma should be included as a differential diagnosis in children presenting with tumors in the fourth ventricle. The contour of the tumor on MRI and its intensity on DWI may be clues for a correct preoperative diagnosis.
脉络丛乳头状瘤很罕见，占所有颅内肿瘤的比例不到1%。在儿童中，这些肿瘤大多起源于侧脑室，而在成人中主要位于第四脑室。我们报告了3例第四脑室脉络丛乳头状瘤患儿，分别为1名5个月大的女孩和2名8岁及15岁的男孩。女婴表现为巨头畸形和颅内压升高的体征，2名男孩表现为小脑体征。磁共振成像（MRI）显示肿瘤强化良好，呈菜花状轮廓并伴有脑积水。在1例病例中，扩散加权成像（DWI）显示肿瘤信号等强，明显不同于髓母细胞瘤常见的高信号。通过枕下开颅术，我们成功地对这些肿瘤进行了全切或次全切，且无后遗症。在随后的2至9年中，所有肿瘤均未复发。总之，对于第四脑室有肿瘤的儿童，应将脉络丛乳头状瘤纳入鉴别诊断。MRI上肿瘤的轮廓及其在DWI上的信号强度可能是术前正确诊断的线索。
