Abstract
Colloid cysts are the commonest masses of the third ventricle. Third ventricle neoplasms are uncommon. They include tumors arising from the choroid plexus (papillomas, carcinomas), tumors arising from other than the choroid plexus (ependymomas, meningiomas), metastases, and lymphoma. Choroid plexus tumors usually occur in the lateral ventricle in children and fourth ventricle in adults, and often present with hydrocephalus. We herein describe the extremely rare occurrence of third ventricle choroid plexus papilloma in a 35-year-old man who presented to the emergency department with a long history of intermittent headaches, occasionally associated with photophobia. CT and MR imaging revealed a lobulated ovoid lesion in the third ventricle with minimal extension into the right lateral ventricle through the foramen of Monro, causing mild ventricular dilatation. Surgical resection was performed and histopathology revealed choroid plexus papilloma.
Highlights
The choroid plexus within the ventricles is responsible for producing cerebrospinal fluid (CSF)
On the basis of histology, they are classified into choroid plexus papilloma (CPP, WHO grade I), atypical CPP (WHO grade II), and choroid plexus carcinoma (CPC, WHO grade III)
They are usually located in the lateral ventricle in children and in the fourth ventricle in adults; only about 5% occur in the third ventricle [2,3]
Summary
The choroid plexus within the ventricles is responsible for producing cerebrospinal fluid (CSF). An unenhanced CT scan of the head was performed, which revealed a lobulated ovoid well-defined hyperdense lesion at the anterior aspect of the third ventricle, extending into the foramen of Monro and slightly protruding into the anterior horn of right lateral ventricle (Figure 1). It measured 16 mm in maximal dimension, had a CT density of about 65 HU, and contained tiny specks of calcification. Sagittal (a) and axial (b) images demonstrate a hyperdense lesion (orange arrows) at the anterior third ventricle, extending to the foramen of Monro and protruding into the anterior horn of right lateral ventricle The patient complained of mild intermittent right-sided headache which was different from the headache he experienced prior to surgery
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