Congenital Choroid Plexus Papilloma of Right Ventricle Following Treatment with Phlebotonic during Pregnancy

An extremely rare congenital choroid plexus papilloma of right ventricle of the brain was diagnosed in a newborn at three weeks of age. Due to the increasing production of the liquor the tumor was removed surgically 2 days later. The baby was exposed to flavonoids, Diosmin and Hesperidin (DH) during fetal development due to maternal treatment regimens of posttrombotic venal insufficiency. Flavonoids, as “plant origin” have often been considered to be safe and due to the venotonic and tissue protective properties are mainly used to cure chronic venous insufficiency in human. However, DH has not been used during pregnancy and even though being useful to mother, the benefits of DH may be reversed to unfavorable effect for developing fetus. Especially since flavonoids play a dual role in mutagenesis and carcinogenesis depending of certain member of flavonoid or animal tissue used in experiment. Evidence of putative tumorigenic side-effect of DH mediated by cellular DNA damage directly, via oxidative stress, by interacting with cellular aryl hydrocarbon receptor or affecting vascularization processes via expression of growth factors, has been available since 1998 and is in constant growth. Here we draw attention to the safety of DH, which has not been proved yet, at least during pregnancy. Therefore, special precaution should be taken when DH is desired to use from the beginning of pregnancy and for a long period during pregnancy. The data available today, either directly or indirectly indicate the risk for congenital vascular tumors in human fetus if exposed to DH.