Luo Wei, Liu Hai, Li Jiaxin, Yang Jun, Xu Yulun
Department of Neurosurgery, Capital Institute of Pediatrics, Chaoyang District, Beijing, China.
Department of Neurosurgery, China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Dongcheng District, Beijing, China.
World Neurosurg. 2016 Nov;95:117-125. doi: 10.1016/j.wneu.2016.07.094. Epub 2016 Aug 6.
Choroid plexus papillomas (CPPs) of the cerebellopontine angle (CPA) are extremely rare. We present a series of 21 cases operated on in the last 7 years at our institution.
During the period from January 2008 to October 2015, we encountered 102 histologically established cases of CPPs, of which 21 were located in the CPA region. Clinical profiles, radiologic features, surgical procedures, intraoperative findings, and outcomes were extracted from the patient records and neuroimaging data.
The 21 CPPs in the CPA region accounted for 20.5% of all CPPs. Two of the tumors occurred in pediatric patients. Tumor size was 2.5-4.7 cm. The rate of calcification was higher in the CPPs in the CPA region. Peritumoral cysts and cysts with small nodules were observed in our cases. A far lateral suboccipital approach was chosen for CPPs protruding inferiorly into the foramen magnum region (n = 14), and a suboccipital retrosigmoid approach was chosen for the other tumors. Total resection was achieved in 18 patients, and subtotal resection was achieved in 3 patients. During the follow-up period, only 1 patient experienced recurrence 32 months after the first operation. The recurrence turned out to be an atypical CPP.
CPPs in the CPA region cannot be easily differentiated from other tumors preoperatively. Cysts and calcifications appear on neuroimaging. CPPs in the CPA region usually protrude inferiorly into the foramen magnum region. As much tumor should be removed as possible to avoid recurrence and malignant transition.
小脑桥脑角（CPA）脉络丛乳头状瘤（CPP）极为罕见。我们报告了本机构在过去7年中手术治疗的21例该类病例。
2008年1月至2015年10月期间，我们遇到102例经组织学确诊的CPP病例，其中21例位于CPA区域。从患者病历和神经影像数据中提取临床资料、影像学特征、手术方法、术中发现及结果。
CPA区域的21例CPP占所有CPP的20.5%。其中2例肿瘤发生于儿童患者。肿瘤大小为2.5 - 4.7厘米。CPA区域CPP的钙化率较高。在我们的病例中观察到瘤周囊肿和带有小结节的囊肿。对于向下突入枕骨大孔区的CPP（n = 14），选择远外侧枕下入路，对于其他肿瘤选择枕下乙状窦后入路。18例患者实现全切，3例患者实现次全切。在随访期间，仅1例患者在首次手术后32个月出现复发。复发肿瘤为非典型CPP。
CPA区域的CPP术前不易与其他肿瘤区分。神经影像上可见囊肿和钙化。CPA区域的CPP通常向下突入枕骨大孔区。应尽可能多地切除肿瘤以避免复发和恶变。
