Fetal choroid plexus lesions. Relationship of antenatal sonographic appearance to clinical outcome.

The sonograms and clinical outcomes of 31 fetuses with antenatally detected choroid plexus lesions were retrospectively reviewed. Lesions were classified as simple cysts in 22 cases (71%) and complex lesions in 9 (29%). Simple cysts tended to be smaller in size than the complex lesions and no adverse sequelae were attributed to the sonographic detection of simple cysts. Although complex choroid plexus lesions appeared to be an incidental finding in seven of nine cases (78%), one of the remaining fetuses developed ventriculomegaly with focal cerebral cortical thinning and in utero viral infection was suspected in the other. Amniocentesis was performed in nine patients (five with simple cysts and four with complex lesions) and no chromosomal abnormalities were detected during the study period, although after these data were collected we encountered a fetus in which bilateral large complex choroid plexus lesions were associated with trisomy 18. These findings suggest that antenatally detected choroid plexus lesions are more variable in appearance than previously recognized. We consider fetuses with small simple cysts and otherwise normal sonograms to be at relatively low risk for developing adverse sequelae and recommend repeat sonography in 1 to 2 months to confirm the benign nature of the process. The presence of large and/or complicated lesions is of more concern, although the majority of these lesions (78%) also represented an incidental finding. We suggest consideration of amniocentesis, TORCH titers, and close sonographic follow-up of pregnancies with large or complex choroid plexus lesions.