Intralesional abscess in choroid plexus carcinoma

Background: Choroid plexus carcinoma (CPC) is a rare, aggressive intraventricular tumour that predominantly affects young children. While CPC typically presents with hydrocephalus and mass effect, intratumoral abscess formation has not been previously documented. Case Presentation: We report the case of a previously healthy 3-year-old female presenting with central facial hemiparesis and anisocoria. Imaging revealed a solid-cystic, contrast-enhancing lesion in the left ventricular atrium with spinal dissemination. Endoscopic-guided total resection via a parietal approach was performed, revealing a friable, hemorrhagic mass. Histopathology confirmed CPC with high proliferative index (Ki-67: 70%). Postoperative treatment followed the HEAD START III chemotherapy protocol without hematopoietic stem cell transplantation, followed by craniospinal radiotherapy. The patient remains recurrence-free after 12 months of follow-up. Conclusion: This case highlights the successful management of a CPC complicated by an intratumoral abscess, an unprecedented presentation. Total surgical resection followed by multiagent chemotherapy and radiotherapy resulted in favourable early outcomes. Given CPC’s rarity and variable presentation, individualised, multidisciplinary approaches are essential.