Adult Choroid Plexus Papilloma: Cause of Sudden Death
# Deptt. of Forensic Medicine, Gandhi Medical College, Bhopal. 462001, E mail: firstname.lastname@example.org
Choroid plexus papilloma (CPP) is a rare, benign neoplasm, relatively more common in childhood. It is associated with signs and symptoms of increased intracranial pressure, frequently in association with obstructive hydrocephalus. CT and MRI are the investigations of choice and are diagnostic. Sudden deaths have been reported, but are very unusual. A 41 year old male was brought for medico-legal autopsy examination on ground of sudden death. He was reported to have headaches over a long period of time. On autopsy examination, massive subarachnoid hemorrhage was seen on both the cerebral hemispheres and cerebellum. A cyst measuring about 1cm diameter was found in choroid plexus of right lateral ventricle.
On histopathological examination, it was found to be a choroid plexus papilloma. Calcification was also evident in the papilloma. From medico-legal aspect, the present case reveals an unusual cause for sudden death in an adult male. The pathology could have been diagnosed easily by CT scan or MRI. When diagnosed, it has good survival rate, the morbidity depending on the extent of pathological effects. The present case was likely to have survived having minimal effects with appropriate treatment had he been diagnosed. The pathology is rare and a suspicion for this pathology in the adult male was not expected, but a CT scan to investigate chronic headache was warranted. Absence of such a suggestion leading to death, which could have been preventable, is sufficient ground for charge of professional negligence.
Sub-Arachnoid Haemorrhage, Intracranial Tumours, Choroid Plexus Papilloma.