İnfant koroid pleksus tümörlerinde tedavi yaklaşımı: tek merkez deneyimi

Giriş: Koroid pleksus gebeliğin 6. haftasında nöroepitelial duvardan gelişmeye başlar. Bu hücrelerden köken alan koroid pleksus tümörlerinin geniş spektrumlu histolojik ve biyolojik özellikleri bulunmaktadır. İntrakranial tümörlerin % 0.2-1ini oluştururlar. Hemen her zaman artmış kafa içi basınç bulguları ile birliktedirler. Tanıda kompüterize tomografi ve manyetik rezonans görüntüleme esastır. Tedavi ise gros total rezeksiyondur. Çalışmamızın amacı her iki lateral ventrikülü ve üçüncü ventrikülü dolduran nadir görülen diffüz villöz hiperplazi olgusunu sunmak ve koroid plexus tümölerinde tedavi yaklaşımı ve cerrahi sonuçları tartışmaktır.Gereç ve Yöntem: 2011 ve 2017 yılları arasında 11 hastaya cerrahi uyuladık: 9 olguda koroid plexus papillomu, 1 olguda atipik koroid plexus papillomu ve 1 olguda diffüz villöz hiperplazi mevcuttu. Olguların en küçüğü 2 aylık en büyüğü 12 aylık olup ortalama yaş 8.6 ay idi. Olguların 4 ü kız, 7 si erkekti. Tümör olguların 7 sinde sol, 3 ünde sağ lateral ventrikülde 1 inde her iki lateral ventrikül ve 3 ventrikülde idi. Tüm olgularda tanı ve takip radyolojik inceleme ile gerçekleştirildi.Bulgular: Hastalarımızın tümünde artmış kafa içi basıncına bağlı bulgular vardı ve 3 hastamıza hidrosefali nedeni ile ventriküloperitoneal şant uygulandı. Ortalama takip süremiz 3.6 yıl olup hastalarımızın hepsi yaşamaktadır.Sonuç: Koroid pleksus tümörleri tedavisinde gros total eksizyon esastır.

Anahtar Kelimeler:

Koroid pleksus tümörü, artmış kafa içi basıncı, şant, hidrosefali

Therapeutic approach to choroid plexus tumors of infants: single center experience

Purpose: Choroid plexus develops at the 6th week of gestation from neuroepithelial lining. Choroid plexus tumors, originating from these cells have wide spectral hystological and biological features. They constitute 0,2-1% of intracranial tumors. They almost mostly present with raised intracranial pressure symptoms. Computeried tomography and magnetic resonance imaging are essential in diagnosis. Therapy is gross total resection. The aim of this study is to present a rare case with diffuse villous hyperplasia filling both of the lateral ventricles and the third ventricle and to discuss the therapeudic approach and surgical results of choroid plexus tumors. Materials and Methods: Between 2011 and 2017 we performed surgery to 11 patients; 9 with choroid plexus papilloma, 1 with atypical choroid plexus papilloma and 1 with diffuse villous hyperplasia. The youngest patient was two months old, the oldest one was 12 months and the average age was 8.6 months. Four cases were female, seven were male. The tumor was at the left lateral ventricle in seven and at the right lateral ventricle in three cases. The tumor was at the both lateral ventricles and third ventricle in one case. All of the cases were diagnosed and followed up with radiological investigations. Results: All of our patients presented with raised intracranial pressure and 3 of them underwent ventriculoperitoneal shunt application because of hydrocephalus.Average postoperative follow up period is 3.6 years and all the cases are alive.Conclusion: Gross total excision is essential for choroid plexus tumors.

Keywords:

Choroid plexus tumor, raised intracranial pressure, shunt, hydrocephalus,

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