Imaging with thallium scan and MRI findings in combination with EBV PCR positive CSF allowed for the presumptive diagnosis of EBV-associated primary CNS lymphoma.
Highly active anti-retroviral therapy (HAART) was reinitiated.
Gross total resection (GTR) was achieved in 77.8% of CPCs and 70.1% of CPPs.
Almost 17% of CPCs were treated with radiation versus only 0.9% of CPPs.
More than 98% of patients with CPP were alive at the last follow-up, versus 61% of CPC patients.
For CPC, surgery was significantly associated with increased survival, but contrary to previous reports, extent of surgical resection was not associated with survival.
Head MRI revealed 3-cm thick-walled ring-enhancing lesion in right basal ganglia. EBV DNA was detected by PCR in CSF without peripheral viremia.
4 out of 6 pts who received radiotherapy are alive versus 1 out of 4 without radiotherapy. The median EFS in case of total resection is 39 months versus 16 in case of partial resection.
CONCLUSIONS: In this short series of very rare cancers, age and tumor size do not seem to be prognostic factors while total resection and radiotherapy seem to be essential. INTRODUCTION: Choroid plexus papillomas (CPPs) and carcinomas (CPCs) are rare neoplasms that affect mostly children.
Within the next 5 months she received 8 cycles of alternating Methotrexate (4000 mg/m2/dose on Day 1) and Rituximab (375 mg/m2/dose on Day 8).
Supportive care included leucovorin rescue and urine alkalinization.