Choroid Plexus Tumors: Insights from a 13-Year Single-Institution Series

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Background Choroid plexus tumors (CPTs) are rare intraventricular neoplasms with diverse clinical and histopathological features. Their variable presentation and surgical challenges, particularly in pediatric patients, make detailed institutional experiences valuable for guiding management and understanding outcomes. Methods We retrospectively reviewed all patients treated for CPTs at the Neurosurgery Department of Habib Bourguiba University Hospital between January 2010 and December 2023. Clinical, radiological, surgical, histopathological, and outcome data were analyzed. Imaging included CT and MRI; histopathology assessed cellularity, pleomorphism, mitotic activity, necrosis, and immunohistochemistry. Surgical approach, cerebrospinal fluid diversion, perioperative complications, adjuvant therapy, and long-term outcomes were recorded. Results Seven patients were included (median age 2 years, range 2 months–28 years; 5 females). Histology revealed four choroid plexus papillomas (CPPs) and three choroid plexus carcinomas (CPCs). Tumor locations were lateral ventricles (n=5), third ventricle (n=1), and fourth ventricle/CPA (n=1). Gross total resection was achieved in all CPPs, with favorable long-term outcomes and minimal morbidity. CPCs were more vascular and complex to resect; one patient died intraoperatively, another shortly postoperatively, and the third developed severe postoperative complications before adjuvant therapy. Ki-67 indices ranged from <1% in CPPs to 40% in CPCs. CSF diversion was required in two patients. Conclusions CPTs demonstrate considerable heterogeneity in presentation, histology, and outcomes. Complete surgical resection is associated with excellent prognosis in CPPs, whereas CPCs present greater surgical and postoperative challenges. This series underscores the importance of early diagnosis, careful surgical planning, and multidisciplinary management to optimize outcomes across the CPT spectrum.

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