{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,7]],"date-time":"2026-11-07T05:18:48Z","timestamp":1794028728117,"version":"4.8.0"},"reference-count":37,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2025,1,11]],"date-time":"2025-01-11T00:00:00Z","timestamp":1736553600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Children"],"abstract":"<jats:p>Background: Intracranial choroid plexus tumors (CPT) are rare and primarily affect young children. Leptomeningeal dissemination (LMD) has been reported not only in high-grade choroid plexus carcinoma (CPC) but also in lower histological grades; however, a systematic evaluation of CPT-specific imaging characteristics remains lacking. Methods: We analyzed the imaging characteristics of LMD in a single-center pediatric cohort of 22 CPT patients (thirteen choroid plexus papilloma (CPP), six atypical choroid plexus papilloma (aCPP), three CPC), comparing LMD features with those of the primary tumor. Additionally, we examined the correlation between resection status and LMD development during follow-up. Results: At diagnosis, we observed true LMD in three (two CPCs, one CPP) and pseudo-LMD in one case (CPP). During follow-up, two CPP patients developed cystic LMD, and one aCPP patient developed a solid metastasis. LMD had characteristics of the primary tumor in 3\/4 cases. Incomplete resection was associated with a higher risk of LMD (p = 0.025). Conclusions: LMD can occur in both high- and lower-grade CPT, presenting at diagnosis as well as in relapsed lower-grade cases. Notable MR-imaging features include pseudo-LMD at diagnosis and cystic LMD in relapsed CPP cases. Incomplete tumor resection may increase the risk of LMD, although further validation is needed.<\/jats:p>","DOI":"10.3390\/children12010082","type":"journal-article","created":{"date-parts":[[2025,1,13]],"date-time":"2025-01-13T09:49:17Z","timestamp":1736761757000},"page":"82","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Leptomeningeal Dissemination in Choroid Plexus Tumors: Magnetic Resonance Imaging Appearance and Risk Factors"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-1403-5430","authenticated-orcid":false,"given":"Daniel","family":"Nunes do Espirito Santo","sequence":"first","affiliation":[{"name":"Department of Neuroradiology, University Hospital W\u00fcrzburg, D-97080 W\u00fcrzburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Monika","family":"Warmuth-Metz","sequence":"additional","affiliation":[{"name":"Department of Neuroradiology, University Hospital W\u00fcrzburg, D-97080 W\u00fcrzburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Camelia-Maria","family":"Monoranu","sequence":"additional","affiliation":[{"name":"Institute of Pathology, Department of Neuropathology, University of W\u00fcrzburg, D-97080 W\u00fcrzburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Hasselblatt","sequence":"additional","affiliation":[{"name":"Institute of Neuropathology, University Hospital M\u00fcnster, D-48149 M\u00fcnster, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Thomas","sequence":"additional","affiliation":[{"name":"Institute of Neuropathology, University Hospital M\u00fcnster, D-48149 M\u00fcnster, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Torsten","family":"Pietsch","sequence":"additional","affiliation":[{"name":"Institute of Pathology, University Hospital Bonn, D-53127 Bonn, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J\u00fcrgen","family":"Krau\u00df","sequence":"additional","affiliation":[{"name":"Section of Pediatric Neurosurgery, Department of Neurosurgery, University Hospital W\u00fcrzburg, D-97080 W\u00fcrzburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tilmann","family":"Schweitzer","sequence":"additional","affiliation":[{"name":"Section of Pediatric Neurosurgery, Department of Neurosurgery, University Hospital W\u00fcrzburg, D-97080 W\u00fcrzburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5849-8671","authenticated-orcid":false,"given":"Brigitte","family":"Bison","sequence":"additional","affiliation":[{"name":"Diagnostic and Interventional Neuroradiology, Faculty of Medicine, University of Augsburg, D-86156 Augsburg, Germany"},{"name":"Neuroradiological Reference Center for the Pediatric Brain Tumor (HIT) Studies of the German Society of Pediatric Oncology and Hematology, Faculty of Medicine, University Augsburg, D-86156 Augsburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8099-5903","authenticated-orcid":false,"given":"Matthias","family":"Eyrich","sequence":"additional","affiliation":[{"name":"Department of Pediatric Hematology and Oncology, University Hospital W\u00fcrzburg, D-97080 W\u00fcrzburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6375-2320","authenticated-orcid":false,"given":"Uwe","family":"Kordes","sequence":"additional","affiliation":[{"name":"Pediatric Hematology and Oncology, University Medical Center Hamburg-Eppendorf, D-20246 Hamburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3216-8452","authenticated-orcid":false,"given":"Denise","family":"Obrecht-Sturm","sequence":"additional","affiliation":[{"name":"Pediatric Hematology and Oncology, University Medical Center Hamburg-Eppendorf, D-20246 Hamburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mirko","family":"Pham","sequence":"additional","affiliation":[{"name":"Department of Neuroradiology, University Hospital W\u00fcrzburg, D-97080 W\u00fcrzburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0148-4652","authenticated-orcid":false,"given":"Annika","family":"Quenzer","sequence":"additional","affiliation":[{"name":"Department of Neuroradiology, University Hospital W\u00fcrzburg, D-97080 W\u00fcrzburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,1,11]]},"reference":[{"key":"ref_1","unstructured":"IARC (2022). Central Nervous System Tumours, IARC."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"151","DOI":"10.1007\/s11060-014-1616-x","article-title":"Choroid Plexus Tumor Epidemiology and Outcomes: Implications for Surgical and Radiotherapeutic Management","volume":"121","author":"Cannon","year":"2015","journal-title":"J. Neurooncol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"599","DOI":"10.1007\/s11060-021-03942-0","article-title":"Final Results of the Choroid Plexus Tumor Study CPT-SIOP-2000","volume":"156","author":"Wolff","year":"2022","journal-title":"J. Neurooncol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"925","DOI":"10.1007\/s00401-015-1434-z","article-title":"Pediatric Atypical Choroid Plexus Papilloma Reconsidered: Increased Mitotic Activity Is Prognostic Only in Older Children","volume":"129","author":"Thomas","year":"2015","journal-title":"Acta Neuropathol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"790","DOI":"10.1093\/neuonc\/nov322","article-title":"Methylation Profiling of Choroid Plexus Tumors Reveals 3 Clinically Distinct Subgroups","volume":"18","author":"Thomas","year":"2016","journal-title":"Neuro-Oncology"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"469","DOI":"10.1038\/nature26000","article-title":"DNA Methylation-Based Classification of Central Nervous System Tumours","volume":"555","author":"Capper","year":"2018","journal-title":"Nature"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"398","DOI":"10.3171\/2012.8.PEDS12132","article-title":"Treatment of Choroid Plexus Tumors: A 20-Year Single Institutional Experience","volume":"10","author":"Bettegowda","year":"2012","journal-title":"J. Neurosurg. Pediatr."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"770","DOI":"10.1007\/s00234-004-1238-7","article-title":"Choroid Plexus Carcinomas in Children: MRI Features and Patient Outcomes","volume":"46","author":"Meyers","year":"2004","journal-title":"Neuroradiology"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"383","DOI":"10.1007\/s11060-009-9936-y","article-title":"Atypical Choroid Plexus Papilloma: Clinical Experience in the CPT-SIOP-2000 Study","volume":"95","author":"Wrede","year":"2009","journal-title":"J. Neurooncol."},{"key":"ref_10","first-page":"vdaa139","article-title":"Role of Available Adjuvant Therapies Following Surgical Resection of Atypical Choroid Plexus Papilloma-a Systematic Review and Pooled Analysis","volume":"2","author":"Tavallaii","year":"2020","journal-title":"Neurooncol. Adv."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"179","DOI":"10.1007\/s11060-013-1281-5","article-title":"Gross Total Resection Improves Overall Survival in Children with Choroid Plexus Carcinoma","volume":"116","author":"Sun","year":"2014","journal-title":"J. Neurooncol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"126","DOI":"10.3171\/2014.12.PEDS14372","article-title":"Neoadjuvant Chemotherapy Reduces Blood Loss during the Resection of Pediatric Choroid Plexus Carcinomas","volume":"16","author":"Schneider","year":"2015","journal-title":"J. Neurosurg. Pediatr."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"63","DOI":"10.1007\/s11060-021-03843-2","article-title":"Paediatric Atypical Choroid Plexus Papilloma: Is Adjuvant Therapy Necessary?","volume":"155","author":"Hazrati","year":"2021","journal-title":"J. Neurooncol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1","DOI":"10.3171\/CASE22360","article-title":"Cystic Dissemination of Choroid Plexus Papilloma: Illustrative Cases","volume":"4","author":"Johnson","year":"2022","journal-title":"J. Neurosurg. Case Lessons"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"757","DOI":"10.3171\/jns.1998.88.4.0757","article-title":"Diffuse Craniospinal Seeding from a Benign Fourth Ventricle Choroid Plexus Papilloma: Case Report","volume":"88","author":"Leblanc","year":"1998","journal-title":"J. Neurosurg."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"842","DOI":"10.1212\/01.wnl.0000167136.64675.9e","article-title":"Diffuse Craniospinal Choroid Plexus Papilloma with Involvement of Both Cerebellopontine Angles","volume":"65","author":"Doglietto","year":"2005","journal-title":"Neurology"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"348","DOI":"10.1159\/000525746","article-title":"Rare Case of Pediatric Disseminated Choroid Plexus Papilloma: Literature Review and Call for Reclassification","volume":"57","author":"Yaghi","year":"2022","journal-title":"Pediatr. Neurosurg."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"777","DOI":"10.1007\/s11060-018-2900-y","article-title":"A Unique Presentation of an Adolescent with Disseminated Atypical Choroid Plexus Papilloma","volume":"139","author":"Johnston","year":"2018","journal-title":"J. Neurooncol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"62","DOI":"10.1016\/j.surneu.2005.09.023","article-title":"Variations of Disseminated Choroid Plexus Papilloma: 2 Case Reports and a Review of the Literature","volume":"66","author":"McCall","year":"2006","journal-title":"Surg. Neurol."},{"key":"ref_20","first-page":"1811","article-title":"Imaging Characteristics of Wingless Pathway Subgroup Medulloblastomas: Results from the German HIT\/SIOP-Trial Cohort","volume":"40","author":"Stock","year":"2019","journal-title":"AJNR Am. J. Neuroradiol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1351","DOI":"10.1148\/93.6.1351","article-title":"An Operative Staging System and a Megavoltage Radiotherapeutic Technic for Cerebellar Medulloblastomas","volume":"93","author":"Chang","year":"1969","journal-title":"Radiology"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"60401","DOI":"10.18632\/oncotarget.19553","article-title":"Added Value of Diffusion Weighted Imaging in Pediatric Central Nervous System Embryonal Tumors Surveillance","volume":"8","author":"Morana","year":"2017","journal-title":"Oncotarget"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1342","DOI":"10.1007\/s00330-001-1189-x","article-title":"MRI Features of Primary, Secondary and Metastatic Medulloblastoma","volume":"12","author":"Freudenstein","year":"2002","journal-title":"Eur. Radiol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"106345","DOI":"10.1016\/j.clineuro.2020.106345","article-title":"Pediatric Atypical Choroid Plexus Papilloma: Clinical Features and Diagnosis","volume":"200","author":"Chen","year":"2021","journal-title":"Clin. Neurol. Neurosurg."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1186\/s40644-019-0200-1","article-title":"Choroid Plexus Tumours on MRI: Similarities and Distinctions in Different Grades","volume":"19","author":"Lin","year":"2019","journal-title":"Cancer Imaging"},{"key":"ref_26","first-page":"480","article-title":"Purely Cystic Form of Choroid Plexus Papilloma with Acute Hydrocephalus in an Infant. Case Report","volume":"105","author":"Miyagi","year":"2006","journal-title":"J. Neurosurg."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"148","DOI":"10.1016\/j.jocn.2016.04.002","article-title":"Disseminated Choroid Plexus Papillomas in Adults: A Case Series and Review of the Literature","volume":"32","author":"Abdulkader","year":"2016","journal-title":"J. Clin. Neurosci."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"284","DOI":"10.3171\/2017.2.PEDS16526","article-title":"Atypical Choroid Plexus Papilloma: Spontaneous Resolution of Diffuse Leptomeningeal Contrast Enhancement after Primary Tumor Removal in 2 Pediatric Cases","volume":"20","author":"Scala","year":"2017","journal-title":"J. Neurosurg. Pediatr."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"351","DOI":"10.1007\/s00701-018-03781-5","article-title":"Vanishing Diffuse Leptomeningeal Contrast Enhancement in an Infant with Choroid Plexus Papilloma","volume":"161","author":"Cruz","year":"2019","journal-title":"Acta Neurochir."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"723","DOI":"10.1007\/s00701-002-0960-3","article-title":"Diffuse Arachnoidal Enhancement of a Well Differentiated Choroid Plexus Papilloma","volume":"144","author":"Heese","year":"2002","journal-title":"Acta Neurochir."},{"key":"ref_31","first-page":"1100","article-title":"False-Positive Spinal MR Findings for Subarachnoid Spread of Primary CNS Tumor in Postoperative Pediatric Patients","volume":"11","author":"Wiener","year":"1990","journal-title":"AJNR Am. J. Neuroradiol."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"47","DOI":"10.1007\/s11060-006-9300-4","article-title":"Metastasis of a Histologically Benign Choroid Plexus Papilloma: Case Report and Review of the Literature","volume":"83","author":"Jinhu","year":"2007","journal-title":"J. Neurooncol."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"325","DOI":"10.1007\/s00234-023-03275-x","article-title":"Postoperative Disappearance of Leptomeningeal Enhancement around the Brainstem in Glioblastoma","volume":"66","author":"Inoue","year":"2024","journal-title":"Neuroradiology"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"151","DOI":"10.1007\/s11060-017-2561-2","article-title":"A French Retrospective Study on Clinical Outcome in 102 Choroid Plexus Tumors in Children","volume":"135","author":"Siegfried","year":"2017","journal-title":"J. Neurooncol."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"745","DOI":"10.1007\/s00701-019-03832-5","article-title":"Management of Choroid Plexus Tumors-an Institutional Experience","volume":"161","author":"Hosmann","year":"2019","journal-title":"Acta Neurochir."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"1086","DOI":"10.1038\/sj.bjc.6600609","article-title":"Choroid Plexus Tumours","volume":"87","author":"Wolff","year":"2002","journal-title":"Br. J. Cancer"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"427","DOI":"10.1007\/s11060-017-2384-1","article-title":"Choroid Plexus Tumors in Adult and Pediatric Populations: The Cleveland Clinic and University Hospitals Experience","volume":"132","author":"Bahar","year":"2017","journal-title":"J. Neurooncol."}],"container-title":["Children"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2227-9067\/12\/1\/82\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,8]],"date-time":"2025-10-08T10:26:53Z","timestamp":1759919213000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2227-9067\/12\/1\/82"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,1,11]]},"references-count":37,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,1]]}},"alternative-id":["children12010082"],"URL":"https:\/\/doi.org\/10.3390\/children12010082","relation":{},"ISSN":["2227-9067"],"issn-type":[{"value":"2227-9067","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,1,11]]}}}