Hamidah Alias, Rahman Jamal
Department of Pediatrics, Faculty of Medicine, University Kebangsaan Malaysia Medical Center, Kuala Lumpur, Malaysia
Med Sci Case Rep 2017; 4:128-132
Available online: 2017-12-21
Choroid plexus carcinoma (CPC) is an uncommon pediatric brain tumor, affecting mainly very young children. The mainstay of treatment is complete tumor resection. The use of adjuvant therapy includes neoadjuvant chemotherapy or postoperative chemotherapy; irradiation has not yet been established in treatment of CPC. We report two cases of CPC in children, including one child with central nervous system metastases who survive for more than seven years after completion of surgery and adjuvant therapies.
CASE REPORT: Case One was a nine-year-old Chinese boy who presented with clumsiness of gait, symptoms of cerebellar dysfunction, lower back pain, weakness of lower limbs, and loss of weight for six months. A magnetic resonance imaging (MRI) of the brain and spine showed a mass in the right lateral ventricle, right frontal lobe, and posterior fossa ventral to the brain stem, and multiple intraspinal extramedullary tumor nodules. Histopathological examination of the tumor confirmed the diagnosis of CPC. The patient had incomplete surgery followed by craniospinal irradiation (CSI) and chemotherapy consisted of cisplatinum/carboplatinum, etoposide, and vincristine. The patient remains without evidence of active disease for seven years from the completion of therapy. Case Two was a five-year-old Chinese girl who presented with headache, vomiting, and two episodes of generalized tonic clonic seizure prior to admission. A MRI of the brain showed multilobulated heterogenous mass in the right lateral ventricle. Histopathological examination of the tumor confirmed the diagnosis of CPC. The patient had surgery followed by chemotherapy that consisted of carboplatinum, etoposide, and vincristine. She also received irradiation. The patient remains without evidence of active disease 15 months from the completion of therapy.
CONCLUSIONS: Our case report showed that use of adjuvant chemotherapy after surgery for patients with CPC, including those with disseminated central nervous system disease is beneficial.
Keywords: Central Nervous System Diseases, Chemotherapy, Adjuvant, Choroid Plexus Neoplasms