Abstract
Papillomas of the choroid plexus in infancy are relatively rare. Total of only 9 cases, including our two cases, have been reported up to May 1979 in Japan. In this paper, two surgical cases of papillomas in infancy were reported.
Case 1: A 4-month-old female had projectile vomiting, increasing drowsiness, enlarged head with bulging fontanel. Lumbar puncture revealed clear CSF under an increased pressure of 300 mm H2O. RI scintigram revealed a mass of dense uptake in the left posterior-parietal region. Ventriculogram with positive contrast medium demonstrated hydrocephalic condition with a mass of the trigonal part of the left lateral ventricle. Left carotid angiography revealed also marked hypertrophy of the anterior choroid artery and a vascular stain of the mass. A left parietal carniectomy was done. The tumor was exposed through a transcortical incision and removed completely. The histological diagnosis of the tumor was papilloma of the choroid plexus, benign. This case was reported in this magazine previously. Now the patient is doing all right 5 year after the surgery.
Case 2: An 8-month-old female had a tonic clonic generalized convulsion with sudden onset. The attacks occurred repeatedly for 5 days prior to admission. When she was admitted to our department, She was comatose with widely dilated and fixed pupils. Her arms and legs showed fragmentary decerebrate response following deep supraorbital pressure. The respiration lessened in depth and rate but continued to be slightly labored. The anterior fontanel was enlarged and bulged. Cricumference of her head was 49.7 cm. Lumbar puncture revealed bloody CSF. Left carotid angiography followed by ventricular drainage was performed. There was marked hypertrophy of the anterior choroid artery and a vascular stain in the plexus portion. Computed tomograshy demonstrated a high density area in the left parietal region and low density area in the temporal region which showed a porencephalic cyst. As an emergency operation the cyst was found to be a very dilated temporal horn of the left lateral ventricle with xanthochromic fluid. A large tumoro of the choroid plexus in the lateral ventricle was totally removed at the second, radical operation. Three weeks later, V-P shunt was performed because marked hydrocephalic condition was noted. The histological feature showed malignant papilloma of the choroid plexus with ill-defined papillary, tubular structure, pleomorphysm, nuclear atypicality, hyperchromatism, multinucleation and stromal invasion. At six months follow-up after surgery, the patient was mentally retarded and could not hold her head up by herself.
