Fact-sheet: Xanthogranuloma of the plexus choroid


Updated on 08/25/2020 at 4:54 PM

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Definition

Benign neuroepithelial cystic tumor of the choroid plexus.

They are located at the atrium of the lateral ventricles, are symmetric and bilateral, and measure less than 2 cm.

Clinical features

  • Asymptomatic in the vast majority of cases.
  • Occasionally: local mass effect (headaches, intracranial hypertension)

CT

  • Hypodense lesion (identical to the adjacent choroid plexus).
  • Fine peripheral calcifications.

MRI

  • Diffusion: Hyperintense (due to a slightly reduced ADC but mainly to T2 shine-through effect)
  • T2 FLAIR: Hypo-/iso-/hyperintense (depending on the fluid component)
  • T2: Isointense relative to CSF
  • T2 GRE: Hyperintense with hypointense areas due to calcifications.
  • T1: Hypointense
  • T1 with gadolinium injection: Possible delayed enhancement.

Management

Watchful waiting

Differential diagnosis

  • Colloid cyst:
    Located at the foramen of Monro in 99% of cases, arising from the roof of the third ventricle.
    Rounded, hyperdense lesion on CT in two-thirds of cases and hyperintense on T1 in two-thirds of cases, without calcifications
  • Expansile lesions of the lateral ventricles.