Abstract
Choroid plexus papillomas (CPPs) are slow-growing and benign tumors, representing less than 1% of all intracranial neoplasms. They are predominantly located in the lateral ventricles in children, and in the fourth ventricle in adults. Primary CPP over sellar regions is extremely rare. There was previously only one case reported in men.We report the case of a 43-year-old male who initially presented with bilateral temporal hemiapnosia. A brain magnetic resonance imaging (MRI) revealed heterogenous enhanced mass lesion with cyst component compressing upward onto the optic chiasm. A craniopharyngioma was initially suspected. Further endoscopic trans-sphenoidal surgery (ETS) was performed for total tumor resection. After surgery, the patient had visual field improved without tumor recurrence on post-operative MRI in clinical follow-up. Histopathological examination of the lesion confirmed the diagnosis of CPP, with fibrovascular cores covered by a single layer of cuboidal to columnar epithelial cells.CPP is a rare tumor without specific clinical patterns or imaging findings. Therefore, pre-operative differential diagnosis is difficult for this kind of tumor with complete separation from ventricular system. An ETS for total tumor resection provided effective treatment.
Highlights
Choroid plexus papillomas (CPPs) are slow growing, benign tumors, representing less than 1% of all intracranial neoplasms
Previous case reports described unusual CPPs arising from the pineal region [2,3], the third ventricle [4], cerebellopontine angle [5], posterior fossa [3,6], brain stem [7], suprasellar region [8], and sellar region [8,9,10,11,12,13]
We describe a case of CPP in the sellar region, with solid and cystic components of tumor mimicking with craniopharyngioma
Summary
Choroid plexus papillomas (CPPs) are slow growing, benign tumors, representing less than 1% of all intracranial neoplasms. We describe a case of CPP in the sellar region, with solid and cystic components of tumor mimicking with craniopharyngioma. This 43-year-old male without systemic disease complained of blurred vision progressively for almost six months. Anatomical MRI revealed a mass lesion over sellar and suprasellar regions with heterogeneous contrast enhancement, and a cystic component that caused upward compression of the optic chiasm (Figure 1). Pre-operative MRI image revealed a mass lesion (arrows) over sellar region with upward optic nerve compression, presenting as a heterogeneous signal change over T1-weighted image (A: coronal view), and a low signal intensity in the central part surrounded peripheral high signal over T2-weighted image (B: coronal view). C: The tumor cells were negative for glial fibrillary acidic protein (100x magnification)
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