Presentation
A patient with severe headache and intractable vomiting
Patient Data
A frond-like isosignal T1W/T2W intraventricular mass within the 4th ventricle without invasion to cerebellar hemispheres shows marked enhancement following contrast administration. Extension of mass into magendie foramen is seen.
Obstructive hydrocephalus is visible by this mentioned mass associated with periventricular interstitial edema.
Compression of mass on the dorsal aspect of the brain stem is visible.
No DWI restriction is identified.
Case Discussion
Atypical choroid plexus papillomas are WHO grade 2 tumors derived from choroid plexus epithelium with intermediate clinical and pathological features between more indolent choroid plexus papillomas and more aggressive choroid plexus carcinomas.
The differential is essentially that of other choroid plexus tumors:
atypical choroid plexus papilloma: indistinguishable, but far less common
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choroid plexus carcinoma: can be very difficult on imaging alone
almost exclusively found in young children
heterogeneous contrast enhancement
may show parenchymal invasion
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