CASE REPORT article
Front. Surg.
Sec. Neurosurgery
Calcified Choroid Plexus Papilloma of the Temporal Horn Presenting with Seizures in an Adult Without Hydrocephalus: An Illustrative Case
Provisionally accepted
- 1Texas A&M University School of Medicine, Bryan, United States
- 2Houston Methodist Hospital, Houston, United States
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Background: Choroid plexus papillomas (CPPs) are rare, benign tumors that typically occur in pediatric patients and result in hydrocephalus.1 Presentations in an adult featuring seizures, particularly focal impaired awareness seizures, occur infrequently, especially in the absence of hydrocephalus.2 Observations: A 50-year-old female exhibited episodes of temporary unresponsiveness characteristic of a focal impaired awareness seizure. Imaging identified a calcified mesial temporal lesion; EEG revealed epileptiform discharges. Surgical pathology confirmed the presence of CPP. The patient began treatment with levetiracetam and later underwent surgical removal of the tumor. Postoperatively, the patient experienced no seizures and exhibited no neurological deficits. Lessons: While CPPs usually cause hydrocephalus, this case had no ventricular enlargement on imaging. Instead, a calcified CPP diagnostically mimicked a cavernoma by presenting solely with seizures and a calcified intraventricular temporal-horn mass in a 50-year-old adult; typically CPPs present in the fourth ventricle rather than the temporal horn, whereas cavernomas regularly present in the temporal lobe with a classically "popcorn-like" appearance. Thus, CPPs can cause focal seizures via local cortical irritation that is calcified, similarly to a cavernoma; CPPs can also present in a middle-aged adult rather than a pediatric patient and lack the most common diagnostic sign of hydrocephalus. The culminative rarity of a CPP that lacks hydrocephalus, causes seizures, contains calcifications, and manifests later in life make for an incredibly atypical and unique case of CPP. Without pathology, the given symptoms and imaging were more suggestive of a cavernous malformation rather than a CPP, highlighting the importance of biopsy for an accurate diagnosis; early surgical resection is crucial and may be curative.
Keywords: calcification, case report, choroid plexus papilloma, Focal impaired awareness seizures, Hydrocephalus
Received: 07 Oct 2025; Accepted: 16 Feb 2026.
Copyright: © 2026 Dover, McManus, Britz and Powell. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Suzanne Powell
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