Presentation
New onset seizure. Focal deficits on exam. Rule out stroke.
Patient Data
A mass in the right cerebral hemisphere is identified. The bulk of the mass is centered upon the atrium of the right lateral ventricle. This component appears relatively solid, although there are numerous tiny cystic-appearing components within the mass. Around the periphery of the presumed solid nidus, numerous cysts ranging from a few millimeters to nearly three centimeters are seen. The solid component of the mass shows relatively uniform enhancement, and there is a thin enhancement around the periphery of some of the cystic components, as well as in the ependymal surface of the right lateral ventricle, particularly immediately around the mass itself. Moderate surrounding vasogenic edema is also noted.
Additionally, there are numerous small cystic structures around the surface of the brain, most conspicuous in the posterior fossa, particularly along the periphery of the left cerebellar hemisphere, and in the interpeduncular cistern. These cysts do not show any perceptible contrast enhancement.
There is approximately 1 cm of midline shift to the left.
Case Discussion
This is a case of a choroid plexus papilloma in the right lateral ventricle. The patient underwent resection of the mass. Histopathologic analysis of the mass consisted of epithelial tissue in a papillary configuration with microcalcifications with low mitotic figures, typical for choroid plexus tissue. As this tissue was from the mass lesion, it represents a choroid plexus papilloma.