Koroid Pleksus Karsinomu:Santral Sinir Sistemi Papiller Tümörlerinde Ayırıcı Tanı

Yıl 2008, Cilt: 25 Sayı: 2, 67 - 71, 29.12.2009

Gamze Numanoğlu Yurdakan Banu Doğan Gün Burak Bahadır Arzu Sönmez Bektaş Açıkgöz Murat Kalaycı Şükrü Oğuz Özdamar

Öz

Koroid pleksus karsinomu, santral sinir sisteminde görülen nadir bir malign tümördür. Primer koroid pleksus tümörlerinin %20–30 kadarını oluşturur ve en sık lateral ventrikülde yerleşim gösterir. Koroid pleksus karsinomu invazivdir; nekroz ve kanama alanları içerir.
Olgumuz baş ağrısı, bilinç bulanıklığı, uykuya eğilim şikâyetiyle başvuran 4 yaşında kız çocuğudur. Bilgisayarlı beyin tomografisinde sağ temporoparietal bölgede belirlenen kitlenin histopatolojik incelemesinde; tümör hücreleri fibrovasküler bir kor çevresinde papiller yapılar oluşturmakta, beyin parankimini infiltre etmektedir. Yaygın tümör nekrozu alanları gözlenmektedir. Tümör yüksek mitotik aktiviteye sahiptir. Histokimyasal ve immünohistokimyasal incelemeler sonucu tümör müsikarmin ile reaksiyon göstermemiş; tümör hücrelerinde S–100 ile diffüz; GFAP, pankeratin (Klon AE1/AE3) ve CK7 ile fokal pozitif reaksiyon izlenmiştir. Olgu, koroid pleksus karsinomu tanısı almıştır.
Olgu, nadir görülmesi ve santral sinir sisteminde görülen papiller tümörlerin ayırıcı tanısındaki önemi nedeniyle sunulmaktadır.



Choroid Plexus Carcinoma: Differential Diagnosis in Papillary Tumors of Central Nervous System
Choroid plexus carcinoma which is a rare malign tumor of central nervous system. These tumors constitue 20-30% of the primary choroid plexus tumors and are more frequently situate in the lateral ventricle. Choroid plexus carcinoma is invasive and involves areas of necrosis and hemorrhage.
Our case is a 4 year old girl who was admitted to university hospital presented with headache, stupor and lethargy. In cranial computerized tomography, a tumor was detected in right temporoparietal lob. Histopathologically the tumor cells were composed of branching papillary structures surrounding a fibrovascular core and infiltrate in brain parenchyma. Large areas of necrosis were detected within the tumor. High mitotic activity was also present. Tumor were not showed to react with mucicarmen, but diffuse reaction for S-100 and focal positive reaction for GFAP, pankeratin(Clone AE1/AE3 ) and CK7 were observed.
Finally, the tumor was diagnosed as choroid plexus carcinoma.
This case is presented here, because of its rarity and importance in differential diagnosis of papillary tumors of central nervous system.

Anahtar Kelimeler

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Kaynakça

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