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A choroid plexus papilloma is a noncancerous growth within the section of the brain that produces cerebrospinal fluid (CSF). Most papillomas are very small and do not cause noticeable symptoms, but a large or abnormal tumor may increase the production of CSF and lead to excessive pressure in the skull. The condition is most commonly seen in infants and children under the age of five, but a slow-growing choroid plexus papilloma may not be detectable until adulthood. Surgery is necessary when a papilloma causes symptoms to remove the mass and drain excess fluid from the brain.
Choroid plexus tissue is found in the brain's ventricles, tubes that carry CSF throughout the brain and spinal cord. In normal amounts, CSF provides cushioning and protection for delicate brain tissue. If a benign tumor develops in the tissue, however, overactive cells start to produce too much CSF. The fluid can put pressure on the brain and lead to a number of uncomfortable symptoms.
A large choroid plexus papilloma can cause an infant or adult to experience chronic headaches and frequent bouts of nausea and vomiting. A baby may be highly irritable and unable to tolerate feedings, and his or her head can enlarge as fluid production increases. Children and adults often experience confusion and difficulty keeping their balance when standing or walking.
A neurosurgeon can check for a choroid plexus papilloma by performing a series of diagnostic tests. X-rays and computerized tomography scans can reveal a growth, and a spinal tap can confirm the presence of excess CSF. Once a tumor is discovered, a surgeon may extract a tiny sample of tissue to make sure it is not cancerous.
Medications and bed rest can relieve some symptoms related to a choroid plexus papilloma, but surgery is almost always recommended to prevent long-term problems. First, a shunt is inserted into the skull and directed to the abdominal cavity to drain excess CSF. A team of neurosurgeons can then perform a delicate procedure to locate and excise the mass. Following surgery, a patient usually needs to remain in the hospital for several days so doctors can monitor recovery and make sure symptoms do not return.
A choroid plexus papilloma only rarely becomes malignant and threatens to spread to other parts of the brain and spinal cord. If a malignancy is detected during diagnostic tests or surgery, doctors must consider additional treatment measures. A combination of chemotherapy, radiation, surgery, and medications may be needed to combat a spreading tumor. A patient's prognosis depends on how early the cancer is discovered and how widespread it has become before treatment is initiated.
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