Choroid plexus papilloma in spontaneous miscarriage - histopathological findings

Abstract

Introduction: One in every four pregnancies ends in miscarriage, most often prior to the 20th gesta­tion week. Miscarriages are predominantly caused by malformations due to genetic and teratogenic factors. Miscarriage due to a central nervous system (CNS) tumor is extremely rare, with about 100 cases reported worldwide. Materials and Methods: A spontaneous miscarriage in the fourth lunar month was presented to the Department of Anatomy and Cell Biology, Faculty of Medicine, Medical University - Varna `Prof. Dr. Paraskev Stoyanov`, Varna, Bulgaria for project related tissue and organ harvesting. The materi­al was kept in -80°C and all procedures were carried out in accordance with ethical standards. Upon dissection, several abnormalities were noticed and tissue specimens were gathered for further histo­logical evaluation to determine the cause of miscarriage. The specimens were fixed in 10% formalin and embedded in paraffin for staining with hematoxylin and eosin, cresyl violet and Azan. Results: During the opening of the cranial cavity a diffuse subdural hematoma was noticed. Upon at­tempting to extract the CNS the specimen spontaneously fractured, revealing ventricular hematomas and an enlarged foramen magnum. Histological evaluation of the specimen revealed a choroid plexus papilloma (CPP) in the fourth ventricle with pressure deformations of the surrounding brain paren­chyma and cartilaginous tissue forming the foramen magnum at this stage of development. Conclusions: Tumors of the fourth ventricle have a dismal prognosis and quickly lead to the patient`s death, due to compression of the respiratory and cardiac centers. CPP is a very rare entry, comprising a total of 0.5% of brain tumors in adults.