Experience of choroid plexus papilloma in children at Mansoura University Hospital

• Main Authors: Hatem Badr, Ahmad Zaher, Mohamed State, Amr Farid Khalil
• Format: Article
• Language: English
• Published: London Academic Publishing 2019-06-01
• Series: Romanian Neurosurgery
• Subjects: choroid plexus papilloma; surgical resection; complications
• Online Access: https://www.journals.lapub.co.uk/index.php/roneurosurgery/article/view/574

Choroid plexus papilloma (CPP) are rare, benign tumours of neuroectodermal origin; they represent 1-3% of central nervous system (CNS) tumours in paediatric patients. Authors present their experience in the management of such lesion in Mansoura University Hospitals. Methods. For children with Choroid plexus papilloma who were treated via microsurgical excision over 4 years from January 2012 to January 2016 in Mansoura University Hospitals, a retrospective analysis was done for age, sex, clinical manifestations, surgical treatment and follow up. Results. Twenty-three paediatrics were treated over 4 years. Age ranged from (7 months - 8 years). There were 13 female and10 males. Tumours were located in the lateral ventricle in all cases. Features of raised intracranial pressure were the predominant presentation. Total microsurgical excision was achieved in all cases. All cases had intraoperative blood loss < 100 ml with mean Haematocrit 28%. Follow up period (7-53 months). Complete relief of all symptoms was reported in all cases with no mortality. One of our patients needs postoperative ventriculoperitoneal shunt for persistent CSF leakage and another one required subdural peritoneal shunt for persistent subdural CSF collection. Conclusion. Total excision of Choroid plexus papilloma is usually the rule with an excellent outcome. Routine external ventricular drainage for at least 3 days is effective in lowering shunt-dependent cases as it allows the release of bloody CSF and small tumour residue. With proper microsurgical technique through superior parietal lobule to access lateral ventricle then tumour coagulation at the same time of irrigation that helps the tumour to shrink and thus, decrease the incidence of bleeding. The tumour vascular pedicle should be resected with the last part of the tumour to avoid pedicle retraction that may lead to ventricular haemorrhage.