Choroid Plexus Papilloma
A usually benign brain tumor in the fluid-producing choroid plexus
Quick Facts
- Type: Usually benign brain tumor
- Origin: Choroid plexus (makes spinal fluid)
- Common in: Infants and young children
- Key effect: Buildup of fluid in the brain
Overview
A choroid plexus papilloma is a brain tumor that arises from the choroid plexus, the specialized tissue inside the brain's fluid-filled spaces (ventricles) that produces cerebrospinal fluid. This fluid normally cushions and protects the brain and spinal cord. Choroid plexus papillomas are usually benign and slow-growing.
Although these tumors are uncommon, they occur most often in infants and young children, and can also appear in adults. A key feature is that they can cause a buildup of fluid inside the brain, called hydrocephalus, either by producing excess fluid or by blocking its normal flow. Because they are typically benign, many can be successfully treated, often with surgery.
Symptoms
Many symptoms come from increased pressure inside the skull due to fluid buildup. Signs depend on age and include:
- Headaches, often worse in the morning
- Nausea and vomiting
- In infants, a rapidly enlarging head, bulging soft spot, and irritability
- Drowsiness or changes in alertness
- Problems with balance or coordination
- Vision changes
- Seizures in some cases
In babies, an unusually fast-growing head size combined with vomiting or sleepiness should be evaluated promptly.
Causes
The cause of choroid plexus papilloma is usually unknown. It develops when cells of the choroid plexus grow abnormally to form a tumor, for reasons that generally cannot be identified.
A few points about causes:
- Most cases occur without any known cause or family history.
- Rarely, these tumors are associated with inherited cancer-predisposition syndromes.
- They are not contagious.
Risk Factors
- Young age, with many cases in infants and young children
- Rare inherited syndromes that predispose to tumors
For most people, no specific risk factor can be identified.
Diagnosis
Diagnosis combines imaging with examination of tumor tissue:
- MRI: The main imaging test to find the tumor, locate it within the ventricles, and assess any fluid buildup.
- CT scan: Sometimes used, particularly in urgent situations.
- Surgery or biopsy: Examining the tissue confirms the diagnosis and distinguishes a benign papilloma from rarer, more aggressive choroid plexus tumors.
- Assessment of hydrocephalus: Evaluating the degree of fluid buildup and pressure.
Treatment
Treatment is managed by a specialist team and focuses on removing the tumor and relieving fluid buildup.
- Surgery: Complete surgical removal is the main treatment and often cures benign papillomas.
- Treating hydrocephalus: Procedures to drain or divert excess cerebrospinal fluid, such as a shunt, may be needed before or after surgery.
- Monitoring: Follow-up imaging to confirm the tumor has not returned.
- Additional therapy: Rarely needed for benign papillomas, but considered for more aggressive choroid plexus tumors.
Because most are benign, the outlook after complete removal is often good.
When to See a Doctor
See a doctor for persistent headaches, repeated vomiting, drowsiness, or balance problems, and have an infant evaluated for unusual head enlargement or a bulging soft spot. Seek emergency care right away for:
- A first seizure
- Sudden severe headache, confusion, or loss of consciousness
- In infants, a rapidly enlarging head with vomiting or sleepiness
These can indicate dangerous pressure inside the brain and need urgent care.
Frequently Asked Questions
Is a choroid plexus papilloma cancerous?
Most choroid plexus papillomas are benign and slow-growing rather than cancerous. There are rarer, more aggressive choroid plexus tumors, which is why examining the tissue is important to confirm the diagnosis and guide treatment.
Why does this tumor cause fluid buildup in the brain?
The choroid plexus normally makes cerebrospinal fluid. A papilloma can produce extra fluid or block its normal flow, leading to a buildup called hydrocephalus. This raises pressure inside the skull and causes many of the symptoms.
Who gets choroid plexus papillomas?
They are uncommon and occur most often in infants and young children, though they can also appear in adults. In most cases there is no known cause or family history.
How is it treated?
The main treatment is surgery to remove the tumor, which often cures benign papillomas. Fluid buildup may need to be treated with a drainage procedure such as a shunt. Follow-up imaging checks that the tumor has not returned.
What symptoms need emergency care?
Seek emergency care for a first seizure, a sudden severe headache, confusion, or loss of consciousness, or, in infants, a rapidly enlarging head with vomiting or sleepiness. These may signal dangerous pressure inside the brain.
References
- National Cancer Institute (NCI). Childhood Choroid Plexus Tumors Treatment.
- American Brain Tumor Association. Choroid Plexus Tumors.
- St. Jude Children's Research Hospital. Choroid Plexus Carcinoma.
- MedlinePlus, U.S. National Library of Medicine. Brain tumor.