Qi Qichao, Ni Shilei, Zhou Xudong, Huang Bin, Li Xingang
Department of Neurosurgery, Qilu Hospital of Shandong University, Shandong, China; Brain Science Research Institute, Shandong University, Shandong, China.
Department of Neurosurgery, Qilu Hospital of Shandong University, Shandong, China.
World Neurosurg. 2015 Dec;84(6):1660-7. doi: 10.1016/j.wneu.2015.07.004. Epub 2015 Jul 11.
Extraventricular intraparenchymal choroid plexus tumors (CPTs) in the cerebral hemisphere are extremely rare. The aim of this study was to investigate the clinical characteristics, radiologic findings, and surgical outcomes of this atypical type of CPT.
The study comprised 6 patients with pathologically proven extraventricular intraparenchymal CPTs who were surgically treated at Qilu Hospital of Shandong University. The PubMed database was searched for similar cases published before January 2015, and these cases were reviewed.
Patients were 5 (83.3%) men and 1 (16.7%) woman with an average age of 46.5 years. Symptoms and signs of CPT were usually associated with increased intracranial pressure and invasion of functional areas by tumor. Magnetic resonance imaging commonly demonstrated a contrast-enhancing intraparenchymal mass with cysts; hydrocephalus was not observed in any cases. Subtotal resection and gross total resection were achieved in 1 (16.7%) and 5 (83.3%) cases, respectively. There were 3 cases (50.0%) of choroid plexus papilloma, 2 cases (33.3%) of atypical choroid plexus papilloma, and 1 case (16.7%) not otherwise specified. There was a low incidence of postoperative complications, and surgical outcomes of CPTs were satisfactory.
In contrast to typical lesions, extraventricular intraparenchymal CPTs in the cerebral hemisphere are rarely associated with hydrocephalus. Magnetic resonance imaging features are key in preoperative diagnosis; nevertheless, it is difficult to distinguish this atypical type of CPT from other lesions. Surgical removal of the tumor is safe and efficacious.
脑室内实质外脉络丛肿瘤(CPT)在大脑半球极为罕见。本研究旨在探讨这种非典型CPT的临床特征、影像学表现及手术结果。
本研究纳入了6例经病理证实的脑室内实质外CPT患者,均在山东大学齐鲁医院接受了手术治疗。检索PubMed数据库中2015年1月之前发表的类似病例并进行回顾。
患者中男性5例(83.3%),女性1例(16.7%),平均年龄46.5岁。CPT的症状和体征通常与颅内压升高及肿瘤侵犯功能区有关。磁共振成像通常显示为有囊肿的脑室内实质内强化肿块;所有病例均未观察到脑积水。分别有1例(16.7%)实现了次全切除,5例(83.3%)实现了全切除。脉络丛乳头状瘤3例(50.0%),非典型脉络丛乳头状瘤2例(33.3%),未另行分类1例(16.7%)。术后并发症发生率较低,CPT的手术结果令人满意。
与典型病变不同,大脑半球脑室内实质外CPT很少与脑积水相关。磁共振成像特征是术前诊断的关键;然而,将这种非典型CPT与其他病变区分开来很困难。手术切除肿瘤安全有效。