PMC4732257_01
(a) Head computed tomography showing ventricular dilatation and foramen of Monro occlusion with significantly high-density lesions. (b) The coronal view of three-dimensional computed tomography revealed that the high-density lesions continuously extended from the choroid plexus of the lateral ventricles to the third ventricle. (c) Head magnetic resonance imaging is showing modest enhancement of the choroid plexus by gadolinium without an obvious tumoral lump. (d) Postoperative computed tomography showing that the placement of the ventriculo-peritoneal shunt
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F1
Significantly high-density lesions smoothly extended from the choroid plexus of the lateral ventricles to the third ventricle and occupied both sides of the FOM [Figure 1a and b]. Magnetic resonance imaging showed that the choroid plexuses were modestly enhanced with gadolinium, but there was no obvious tumoral lump, which indistinguishable from the contiguous choroid plexus [Figure 1c]. Resection was not selected because the calcified lesions had tightly adhered to the veins and fornix; therefore, the patient underwent ventriculo-peritoneal shunting via the same tract [Figure 1d].
(a and b) Intraoperative view with a flexible neuroendoscope showing an entirely calcified lesion consecutive from the choroid plexus in the ventricle body (a) toward the foramen of Monro (b). Biopsy was performed, and a small specimen was obtained from the relatively less calcified part (a) asterisk
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F2
Egg shell-like entirely calcified lesions that smoothly extended toward the FOM were detected [Figure 2a and b].
(a) Hematoxylin and eosin staining showing a meningioma with abundant psammoma bodies. (b) Immunohistochemical staining for Ki-67 showing a low staining index of <1%
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F3
A histological examination of the specimen revealed a number of psammoma bodies with round and spindle tumor cells [Figure 3a]. Mitosis was scarcely observed, and the immunohistochemical staining index for Ki-67 was <1% [Figure 3b].