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Purpose <p>Choroid plexus tumors (CPT), especially in pediatric patients, present a major surgical challenge due to their hypervascularity and frequent intraventricular location. Preoperative embolization has emerged as a strategy to minimize intraoperative blood loss and improve surgical outcomes, yet its application in large-volume tumors via the anterior choroidal artery (AChA) remains limited.</p> Methods <p>We report a case of a 10-month-old infant with a giant choroid plexus carcinoma (CPC) measuring 189&#xa0;cm³, treated with superselective embolization through the AChA using Squid™ prior to surgical resection. A systematic review was also conducted, including 9 studies on preoperative embolization via AChA for CPTs, with attention to technique, tumor volume, agents used, and outcomes.</p> Results <p>Microcatheterization beyond the plexal point of the AChA enabled safe delivery of the embolic agent, achieving substantial tumor devascularization without ischemic or hemorrhagic complications. Surgical resection was completed without intraoperative blood transfusion or neurological sequelae. The systematic review confirmed the rarity of embolization in tumors exceeding 100&#xa0;cm³, highlighting our case as one of the largest successfully treated using this approach.</p> Conclusion <p>Superselective preoperative embolization of choroid plexus tumors via the anterior choroidal artery is technically feasible and safe when performed beyond the plexal point. In high-risk pediatric cases with large-volume tumors, this strategy can significantly improve surgical safety and should be considered as part of a multimodal treatment approach.</p>

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Superselective anterior choroidal artery preoperative embolization of a giant choroid plexus carcinoma in an infant: case report and systematic review

  • 期刊论文

  • 发表日期：

    2025年10月27日

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  • Gabriel Felipe Lorençato,
  • Luis Gustavo Biondi Soares,
  • Felipe Andreani Camargo Manduco,
  • Victor Lima Amaral,
  • Walter Fagundes,
  • Patrícia Alessandra Dastoli,
  • Leandro de Assis Barbosa

摘要

Purpose

Choroid plexus tumors (CPT), especially in pediatric patients, present a major surgical challenge due to their hypervascularity and frequent intraventricular location. Preoperative embolization has emerged as a strategy to minimize intraoperative blood loss and improve surgical outcomes, yet its application in large-volume tumors via the anterior choroidal artery (AChA) remains limited.

Methods

We report a case of a 10-month-old infant with a giant choroid plexus carcinoma (CPC) measuring 189 cm³, treated with superselective embolization through the AChA using Squid™ prior to surgical resection. A systematic review was also conducted, including 9 studies on preoperative embolization via AChA for CPTs, with attention to technique, tumor volume, agents used, and outcomes.

Results

Microcatheterization beyond the plexal point of the AChA enabled safe delivery of the embolic agent, achieving substantial tumor devascularization without ischemic or hemorrhagic complications. Surgical resection was completed without intraoperative blood transfusion or neurological sequelae. The systematic review confirmed the rarity of embolization in tumors exceeding 100 cm³, highlighting our case as one of the largest successfully treated using this approach.

Conclusion

Superselective preoperative embolization of choroid plexus tumors via the anterior choroidal artery is technically feasible and safe when performed beyond the plexal point. In high-risk pediatric cases with large-volume tumors, this strategy can significantly improve surgical safety and should be considered as part of a multimodal treatment approach.