Choroid Plexus Tumors Flashcards
A 2-year-old patient presents with nausea, vomiting, macrocephaly, and seizures. Imaging showed iso- to hyperdense lesion on CT of brain in the ventricle which is hypointense on T1WI and hyperintense on T2WI multilobulated intraventricular mass classically with projecting fronds and densely enhancing. What are the most common locations of this tumor in descending order?
● A. Third ventricle, then fourth ventricle, then lateral ventricles
● B. Lateral ventricles, then third ventricle, then fourth ventricle
● C. Lateral ventricles, then fourth ventricle, then third ventricle
● D. Third ventricle, then lateral ventricle, then fourth ventricle
● E. None of the above
C. Lateral ventricles, then fourth ventricle, then third ventricle
Atypical choroid plexus papillomas are WHO grade 2 tumors which are located intraventricularly and demonstrate choroid plexus differentiation by histopathological and immunophenotypic features and are characterized by absence of criteria qualifying for diagnosis of choroid plexus carcinoma and which of the following?
● A. More than or equal to 1 mitosis/HPF of 0.23 mm2
● B. More than or equal to 2 mitosis/HPF of 0.23 mm2
● C. More than or equal to 3 mitosis/HPF of 0.23 mm2
● D. More than or equal to 4 mitosis/HPF of 0.23 mm2
● E. More than or equal to 5 mitosis/HPF of 0.23 mm2
B. More than or equal to 2 mitosis/HPF of 0.23 mm2
Choroid plexus carcinoma is a WHO grade 3 tumor that invades the adjacent brain and primarily occurs in the lateral ventricles of children. These tumors are prone to metastasize through CSF. What is the percentage of these tumors metastasized thorough CSF at the time of diagnosis?
● A. 41%
● B. 31%
● C. 51%
● D. 21%
● E. 11%
D. 21%
Following are the histopathological features of choroid plexus carcinoma except?
● A. Increased cellularity
● B. Nuclear pleomorphism
● C. Blurring of the papillary pattern with poorly structured sheets of tumor cells
● D. Mitoses usually more than or equal to 2 mitoses/10 HPF of 0.23 mm2
● E. Necrotic areas
D. Mitoses usually more than or equal to 2 mitoses/10 HPF of 0.23 mm2
Imaging of the entire neuraxis is recommended in choroid plexus carcinoma due to high incidence of drop mets. Which of the following are features of choroid plexus carcinoma on MRI?
● A. Heterogenous signals on T1 and T2 with irregular enhancing margins suggesting subependymal invasion
● B. Edema in adjacent brain
● C. Vascular flow voids in 55% of images
● D. Often hydrocephalus is evident
● E. All of the above
E. All of the above
Which of the following statements is correct regarding treatment of choroid plexus carcinoma?
● A. There is no benefit of surgery in malignant choroid plexus tumors
● B. Chemotherapy benefits all of these patients
● C. Radiotherapy was not shown to improve survival in patients undergoing surgery
● D. Adjuvant chemotherapy should be given to all the patients
● E. All of the above
C. Radiotherapy was not shown to improve survival in patients undergoing surgery
Atypical choroid plexus papillomas are more likely to recur than their grade 1 counterpart. What is the median age of diagnosis of these tumors?
● A. 6 to 8 months
● B. 8 to 10 months
● C. 10 to 12 months
● D. 12 to 14 months
● E. 14 to 16 months
C. 10 to 12 months
Which statement is incorrect regarding treatment and prognosis of grade 1 choroid plexus papilloma?
● A. Choroid plexus papillomas are often cured surgically with total removal
● B. The operation may be difficult because of fragility of the tumor and bleeding from the choroidal arteries
● C. Persistence with second or even third operation is recommended as 5-year survival rate of 84 to 97% can be achieved
● D. Postoperative subdural collections after transcortical tumor excision may occur because of persistent ventriculosubdural fistula which may require subdural peritoneal shunt
● E. Malignant degeneration is common with role of chemotherapy and radiation for these tumors
E. Malignant degeneration is common with role of chemotherapy and radiation for these tumors
What is the common location of choroid plexus papilloma?
● A. Usually infratentorial in adults
● B. A + Supratentorial in children
● C. Supratentorial in adults
● D. C + Infratentorial in children
● E. Equally present supratentorially and infratentorially in adults and children
A. Usually infratentorial in adults
Hydrocephalus in choroid plexus papilloma may result from which of the following?
● A. Overproduction of CSF
● B. Obstruction of CSF outflow
● C. Communicating hydrocephalus due to CSF-borne particulates
● D. Does not occur in choroid plexus papilloma
● E. A, B, and C
E. A, B, and C
A 2-year-old child presented with signs of raised ICP and CT showed hydrocephalus and a densely enhancing multilobulated mass with projecting fronds, within left lateral ventricle. What is the most probable diagnosis?
● A. Ependymoma
● B. Medulloblastoma
● C. Astroblastoma
● D. Choroid plexus papilloma
● E. Ganglioglioma
D. Choroid plexus papilloma
What is the usual extraventricular location of choroid plexus papilloma?
● A. Middle fossa
● B. Cribriform plate
● C. CP angle
● D. Ambient cistern
● E. Suprasellar region
C. CP angle
What is the treatment of postoperative ventriculo-subdural collection in choroid plexus papilloma (CPP) surgery?
● A. Craniotomy and evacuation
● B. Subdural drain
● C. Subdural–peritoneal shunting
● D. Subdural–subarachnoid shunting
C. Subdural–peritoneal shunting
About 40% of choroid plexus carcinomas are associated with which syndrome?
● A. Cowden syndrome
● B. von Hippel Lindau syndrome
● C. Li Fraumeni syndrome
● D. Turcot syndrome
● E. Gardner syndrome
C. Li Fraumeni syndrome
Absence of which mutation is associated with a good prognosis in choroid plexus carcinoma?
● A. TP53
● B. BRAF
● C. ATRX
● D. PTEN
● E. EGFR
A. TP53
