Choroid Plexus Mimicry: Metastatic Papillary Lung Adenocarcinoma in the Fourth Ventricle
31 December 2025
Char Loo Tan, Boon Leong Quah
Abstract
Brain metastases are the most common type of brain tumors, typically presenting as intraparenchymal lesions. Intraventricular or choroid plexus involvement is very rare, posing a significant diagnostic challenge. This case report describes a rare instance of a solitary choroid plexus metastasis from a highly well-differentiated lung adenocarcinoma in a 41-year-old woman. The metastatic tumor's close morphological resemblance to a primary choroid plexus tumor added to the diagnostic difficulty, initially leading to a misdiagnosis of choroid plexus carcinoma. However, further investigation, including detailed immunohistochemistry and the detection of a BRAFV600E mutation, ultimately identified the tumor as a metastatic lung adenocarcinoma. Notably, this choroid plexus metastasis served as the index diagnosis, revealing the previously undiagnosed metastatic lung cancer. This case highlights the critical need to consider metastasis in the differential diagnosis of solitary choroid plexus tumors in adults. Recognizing the cytokeratin staining patterns in choroid plexus tumors, along with the use of organ-specific antibodies and molecular analysis, is essential for achieving an accurate diagnosis and ensuring that patients receive the most appropriate and effective treatment.
Keywords
choroid plexus; lung adenocarcinoma; metastasis; papillary; ventricle.
Reference
- Garrido E, Alqahtani K, Lozouet M, Derrey S, Gilard V: Metastasis of the choroid plexuses: a systematic review of the literature and case illustration. Neurochirurgie. 2023, 69:101412. 10.1016/j.neuchi.2023.101412
- Crisman CM, Patel AR, Winston G, Brennan CW, Tabar V, Moss NS: Clinical outcomes in patients with renal cell carcinoma metastases to the choroid plexus. World Neurosurg. 2020, 140:e7-e13. 10.1016/j.wneu.2020.03.125
- Shapira Y, Hadelsberg UP, Kanner AA, Ram Z, Roth J: The ventricular system and choroid plexus as a primary site for renal cell carcinoma metastasis. Acta Neurochir (Wien). 2014, 156:1469-74. 10.1007/s00701-014-2108-7
- Kitagawa Y, Higuchi F, Abe Y, Matsuda H, Kim P, Ueki K: Metastasis to the choroid plexus from thyroid cancer: case report. Neurol Med Chir (Tokyo). 2013, 53:832-6. 10.2176/nmc.cr2012-0238
- Ikota H, Tanaka Y, Yokoo H, Nakazato Y: Clinicopathological and immunohistochemical study of 20 choroid plexus tumors: their histological diversity and the expression of markers useful for differentiation from metastatic cancer. Brain Tumor Pathol. 2011, 28:215-21. 10.1007/s10014-011-0024-6
- Kristensen MH, Nielsen S, Vyberg M: Thyroid transcription factor-1 in primary CNS tumors. Appl Immunohistochem Mol Morphol. 2011, 19:437-43. 10.1097/PAI.0b013e31820e6baf
- O'Leary CG, Andelkovic V, Ladwa R, et al.: Targeting BRAF mutations in non-small cell lung cancer. Transl Lung Cancer Res. 2019, 8:1119-24. 10.21037/tlcr.2019.10.22
- Behling F, Barrantes-Freer A, Skardelly M, et al.: Frequency of BRAF V600E mutations in 969 central nervous system neoplasms. Diagn Pathol. 2016, 11:55. 10.1186/s13000-016-0506-2
Cite
Tan C, Quah B (December 31, 2025) Choroid Plexus Mimicry: Metastatic Papillary Lung Adenocarcinoma in the Fourth Ventricle. Cureus 17(12): e100521. doi:10.7759/cureus.100521


