Clinical Presentation and Evaluation

These tumors usually present with hydrocephalus. The cause of the hydro-cephalus can either be obstruction of the CSF pathways or overproduction of CSF, since the neoplastic tissue is still capable of secreting CSF. The MRI appearance of a choroid plexus papilloma is characteristic: a brightly enhancing mass with well-defined papillary structure (Chapter 2, Fig. 15). There is clear demarcation between the tumor and the surrounding ventricular wall. Often the blood vessels supplying the tumor, either the anterior or posterior choroidal arteries, are hypertrophied and can be identified on MRI or MR angiography. These vessels can sometimes be embolized preoperatively.

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