Exophytic choroid plexus papilloma of the fourth ventricle presenting with cerebrospinal fluid rhinorrhea: a case report.

Background: Choroid plexus papillomas are rare benign neoplasms that arise from the ventricular choroid plexus and are considered to be of ependymal origin. They are slow-growing lesions, are commonly associated with hydrocephalus, and are prone to hemorrhage spontaneously. Most of them are located in the posterior fossa in adults, the fourth ventricle being the most common location.

Case Description: We report a case of a 61-year-old male patient with a fourth ventricular exophytic choroid plexus papilloma extending caudally into the foramen magnum causing obstructive hydrocephalus. In February 2005, he presented with spontaneous CSF rhinorrhea to an ENT surgeon and underwent an endoscopic transnasal repair. Six months later, he came to us with progressive loss of vision due to raised intracranial pressure.

Conclusion: The lesion may not be detected on CT scans and MRI scan is the imaging modality of choice. Excision of the tumor takes precedence over any attempt to repair the fistula, as many a time, the CSF leak may stop.