Delayed Lumbar Drop Metastases of Choroid Plexus Carcinoma in an Adult

Background: Choroid plexus carcinoma is an aggressive malignant tumor (WHO Grade III) that usually presents in the lateral ventricles (50%) followed by fourth ventricle (40%), third ventricle (5%), and in multiple locations within the ventricular system (5%). Most of choroid plexus carcinomas are seen in children and they are very rare in adults. Its prognosis is generally poor, but radical surgery, chemotherapy, and radiotherapy can improve the survival. Although cases of drop metastases have been simultaneously diagnosed with the intraventricular localization, to the best of our knowledge no other cases of delayed drop metastases have been reported.

Aim: We report a case of lumbar drop metastasis of choroid plexus carcinoma 11 years following the initial presentation.

Study Design: Case report

Results: We report the case of a 52-year-old lady who 11 years before underwent removal of right occipital horn choroid plexus carcinoma; 3 and 6 years later she had local recurrences treated with surgery and radiotherapy. She presented with 8-month history of lower back pain, bilateral leg pain, and urinary urgency. A magnetic resonance imaging of the neuroaxis showed a ventral intradural mass at L5, in absence of intracranial recurrences. She underwent L5/S1 laminectomy and excision of the intradural tumor. The postoperative course was uneventful and she had improvement of preoperative symptoms. The histological examination confirmed the diagnosis of choroid plexus carcinoma.

Conclusion: This report shows that choroid plexus carcinoma can metastasize in delayed fashion even in absence of signs of brain recurrences and confirms the importance of extensive neuroimaging during the follow-up.

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