Katoh Masahito, Sawamura Yutaka, Tanaka Shinya, Fujimaki Takamitsu, Hirose Shigehisa, Aida Toshimitsu
Department of Neurosurgery, KKR Sapporo Medical Center, Sapporo, Japan.
Department of Neurosurgery, Sawamura Neurology and Neurosurgery Clinic, Sapporo, Japan.
J Neurol Surg A Cent Eur Neurosurg. 2019 Jan;80(1):53-57. doi: 10.1055/s-0037-1615284. Epub 2018 Jul 4.
It is very rare for a choroid plexus tumor to occur intraparenchymally in the absence of a relation to the choroid plexus.
A case of cerebral intraparenchymal choroid plexus tumor in a 30-year-old woman presenting with left hemiparesis is described. Brain magnetic resonance imaging depicted a large cystic mass in the right frontal lobe. Tumor resection was performed by right frontal craniotomy. No connection with the choroid plexus was observed during the operation. Histologically, the tumor exhibited a glandular structure with a papillary pattern suggesting a neoplasm of epithelial origin. Immunohistochemical analyses revealed the tumor as an atypical choroid plexus papilloma.
Immunohistochemical findings, especially regarding Kir7.1, are very important for the differential diagnosis of cerebral intraparenchymal choroid plexus tumors from metastatic tumors. The present case reveals that an atypical choroid plexus papilloma can occur intraparenchymally without an association with the choroid plexus. Intraparenchymal atypical choroid plexus papillomas may have previously been diagnosed incorrectly as metastatic adenocarcinomas of unknown origin.
脉络丛肿瘤在脑实质内发生且与脉络丛无关联的情况极为罕见。
描述了一例30岁女性脑实质内脉络丛肿瘤病例，该患者表现为左侧偏瘫。脑部磁共振成像显示右侧额叶有一个大的囊性肿块。通过右额开颅术进行了肿瘤切除。手术过程中未观察到与脉络丛有连接。组织学上，肿瘤呈现出具有乳头状结构的腺性结构，提示为上皮起源的肿瘤。免疫组化分析显示该肿瘤为非典型脉络丛乳头状瘤。
免疫组化结果，尤其是关于Kir7.1的结果，对于脑实质内脉络丛肿瘤与转移性肿瘤的鉴别诊断非常重要。本病例表明非典型脉络丛乳头状瘤可在脑实质内发生且与脉络丛无关联。脑实质内非典型脉络丛乳头状瘤之前可能被错误诊断为不明来源的转移性腺癌。
