Choroid Plexus Tumor Surgery in New Jersey

T
he best way to treat a choroid plexus tumor is by surgery. The neurosurgeons and medical team at Centers for Neurosurgery, Spine & Orthopedics (CNSO) are known for their compassion, attention to detail, diagnostic accuracy, and surgical skills. Trained at the top medical institutions, each board-certified neurosurgeon at CNSO has ten or more years of experience. The CNSO neurosurgeons only operate at the top neurological centers in New Jersey.

Patients diagnosed with a choroid plexus tumor seek a second opinion on the type of brain tumor they have. Or they may seek a second opinion and assistance in determining the right treatment plan. Regardless of the reason, CNSO has offices across northern New Jersey, making it convenient for patients to seek treatment wherever they reside. Learn more about choroid plexus tumors and any type of brain tumor and the treatments available at CNSO.

What Is a Choroid Plexus Tumor?

A choroid plexus tumor is a central nervous system tumor, that arises from the choroid plexus, a structure that produces cerebrospinal fluid and is located inside the fluid-filled structures of the brain called the ventricles. These types of tumors are rare and more commonly occur in children but can be seen in adults. As the tumor grows, it can cause an overproduction of cerebrospinal fluid as well as block the flow of cerebrospinal fluid causing hydrocephalus and increased pressure in the brain.

Symptoms of Choroid Plexus Tumors

Symptoms of a choroid plexus tumor can vary by patient, depending on the location of the tumor and the age of the patient. Typically, in school-age children, teens, and adults, patients experience worsening headaches due to increased pressure in the head, nausea, vomiting, changes in vision, lethargy, and less commonly seizures. Infants and young children will present with increasing head size, developmental delays, failure to thrive, irritability, vomiting, and lethargy.

How Is a Choroid Plexus Tumor Diagnosed?

• Detailed history: Presenting symptoms guide the medical team’s decision-making and provide important clues and information as to what may be causing a patient’s problem.
• Neurological exam: During this exam, a patient’s vision, hearing, balance, coordination, and reflexes are tested. This can help show which part of the brain might be affected by the tumor. 
• Brain imaging tests: Tests to create images of a patient’s brain may include magnetic resonance imaging (MRI) and computed tomography (CT). An MRI also helps the patient’s neurosurgeon plan for surgery. 

Treatment of Choroid Plexus Tumors

The mainstay of treatment for a choroid plexus tumor is surgery. The type of surgery and the approach are tailored to the location, the size of the mass, and whether it is causing a buildup of fluid inside the brain called hydrocephalus. The neurosurgeons at Centers for Neurosurgery, Spine & Orthopedics have extensive experience with these types of delicate operations and can provide the best possible outcome.

Surgery 

The goal of surgery is to remove all of the brain tumor when possible. However, because delicate and important structures are nearby, neurosurgeons may not be able to safely remove all of the tumor cells. In these cases, patients may require other treatments after surgery.

Patients with choroid plexus tumors often have a buildup of fluid inside the brain and may require a temporary drain to be put inside the fluid-filled part of the brain (ventricles) during surgery to drain the fluid and monitor pressures inside the brain. About 25% of patients will require placement of a ventriculoperitoneal shunt, a permanent internal drain in order to treat the hydrocephalus.

Following surgery, the brain tumor will be evaluated by a pathologist to determine the tumor’s grade. The patient will also undergo more imaging to determine if the tumor was completely removed. Ultimately, the treatment plan, overall outcome, and prognosis are guided by the grade of the brain tumor and whether a complete removal of the tumor was accomplished.

Grades of Choroid Plexus Tumors 

There are three types (Grades) of choroid plexus tumors: 

• Choroid plexus papilloma and atypical choroid plexus papilloma (Grades I and II): These types account for the vast majority of choroid plexus tumors and are noncancerous. These tumors grow slowly and rarely spread to other parts of the brain or spine. 
• Choroid plexus carcinoma (Grade III): These tumors are cancerous and grow faster than noncancerous tumors. They are most likely to spread through the cerebrospinal fluid and invade nearby tissue. 

Grading Accuracy 

What the patient should expect is determined by the grade of the tumor and the extent of resection.

• If the choroid plexus tumor is categorized as Grade I, it is unlikely that the brain tumor will re-grow or return especially if all of the tumor was removed safely. Grade I tumors that are completely removed have an excellent prognosis and outcome, and many are cured. Typically, the only treatment needed following surgery is yearly imaging to monitor for recurrence. 
• Grade II choroid plexus papillomas, are still considered benign but have a higher chance that the tumor will re-grow. Like the Grade I tumors, following successful surgery, these patients are monitored with frequent imaging to evaluate for recurrence. Recurrences are often treated with additional surgery and focused radiation therapy or what is called radiosurgery. 
• Grade III choroid plexus carcinomas are much more aggressive and considered brain cancer. Fortunately, this type of brain cancer is exceptionally rare, and the vast majority of choroid plexus tumors are Grade I or II. For the treatment of Grade III choroid plexus carcinomas, radiation and chemotherapy are routinely recommended following surgery, even if all of the tumor is completely removed.

The team of brain tumor specialists at CNSO individualizes treatment plans which often simply include frequent monitoring with imaging. For recurrences of Grade I or II choroid plexus papillomas, or the initial treatment of Grade III choroid plexus carcinomas following surgery, the treatment plan becomes more complicated and may include further brain tumor surgery, radiation treatment, or chemotherapy.

What Causes a Choroid Plexus Tumor?

The cause of most choroid plexus tumors is not known and most commonly occurs sporadically in individuals without identifiable risk factors. No specific genes or genetic markers have been identified for choroid plexus tumors. Females are affected by choroid plexus tumors slightly more often than males. 

A higher incidence of choroid plexus papillomas can be seen in genetic syndromes that have a higher incidence of brain tumors due to abnormalities in the genes that encode cell growth control. There is a slight correlation in the incidence of a brain tumor with the following conditions:

• Down syndrome 
• Li-Fraumeni syndrome 
• Aicardi syndrome 
• Von Hippel-Lindau syndrome 
• Neurofibromatosis 2 

Prognosis of Choroid Plexus Tumors

A patient may be worried about their prognosis after being diagnosed with a choroid plexus tumor. However, those with a Grade I tumor have a high survival rate. Five years after treatment, the survival rate of a choroid plexus tumor is: 

• Grade I: Nearly 100% 
• Grade II: Around 85% 
• Grade III: Around 50% 

Each choroid plexus tumor is unique, as is its diagnosis and prognosis. Patients should talk with the brain surgeon and medical team at CNSO for more information regarding their diagnosis and treatment options. 

Getting a Second Opinion After an Initial Diagnosis

If another physician has diagnosed a patient with any type of brain tumor, but the patient is looking for further guidance, CNSO can provide a second opinion. Many CNSO patients return for treatment, appreciating the neurosurgery team’s dedication to diagnosis education. Each patient is scheduled for an hour-long consultation, where the brain tumor team reviews: 

• Patient symptoms 
• Medical conditions 
• Previous testing results 
• Diagnosis 
• Treatment options 
• Course of recovery 

The brain tumor specialists at CNSO take the time to learn about each patient, going over all treatment options to find a customized plan that works for them. 

Patients value the consultation practices of the award-winning and board-certified neurosurgeons and orthopedic spine surgeons at CNSO. The CNSO medical staff includes experts in the nervous system, brain, and spine who are specially trained in the diagnosis, treatment, and management of the gamut of brain tumors and disorders of the brain. Patients can be confident that their condition will be handled with their comfort and long-term well-being in mind. 

Schedule an Appointment With Centers for Neurosurgery, Spine & Orthopedics

If a patient believes they have a choroid plexus tumor, it is time to see the highly trained brain specialists at Centers for Neurosurgery, Spine & Orthopedics in northern New Jersey. At CNSO, patients will receive comprehensive and coordinated care, allowing them to return to their lives and favorite activities faster.

Work with CNSO’s leading, board-certified neurosurgeons, specializing in brain tumors, carcinomas, reconstruction surgeons, plastic surgeons, interventional pain management physicians, physiatrists, rehabilitation specialists, and certified physical therapists. CNSO offers multiple convenient locations across northern New Jersey. Patients can contact CNSO today to learn more about choroid plexus tumors and treatment options.