Introduction: The goal of this study was to determine the epidemiology, clinical presentation, associated factors, pathological features and treatment outcome of pediatric meningiomas in a single-center institution.
Methods: Clinical data of 15 patients under 18 years of age operated for meningiomas from January 1994 to December 2010 were reviewed.
Results: They included 9 males and 6 females with a mean age of 13 years. The commonest symptoms at presentation were headaches in 6/15, raised intracranial pressure in 3/15, and seizures in 3/15. The locations of the operated tumors were unique as follows in 12/15: parasagittal 4/12, two in the convexity, two at the skull base, and four others sites. Six children presented with radiation-induced (RT) meningiomas and five had evidence of neurofibromatosis type 2 (NF2). Three patients had multiple meningiomas (all of them had NF2.) Simpson’s grade I excision was achieved in 12/15 (80%). On histopathology, 11/15 (73.3%) was graded I, and 4/15 (26.6%) grade II (atypical). Cytogenetic studies performed in RT meningiomas showed complex chromosomes aberrations. Five tumors recurred, four of which had RT or NF2. During the mean follow up period of 5 years, the majority of cases, 12/15 had a good outcome.
Conclusions: Childhood meningiomas are uncommon lesions with a slight male predominance. Absence of large series with long follow up precludes any definite conclusions on the clinical course and outcome of these tumors. Associated factors (such as RT and NF2), location and extent of excision appear to be more important than histopathological grade in predicting outcome.
Patient Care: Provide access to comprehensive patient health data for patient’s health care team;
Apply clinical decision support at the point of care.
Learning Objectives: By the conclusion of this session, participants should be able to: 1) Describe the importance of meningioma in pediatric series and associate factors as RT and NF2, 2) Discuss, in small groups specific considerations for children 3) Identify an effective treatment for meningioma in pediatric patients
References: 1-Kotecha RS, Junckerstorff RC, Lee S, Cole CH, Gottardo NG (2011) Pediatric meningioma: current approaches and future direction. J Neurooncol 104:1-10
2-Rushing EJ, Olsen C, Mena H, Rueda ME, Lee YS, Keating RF, Packer RJ, Santi M (2005) Central nervous system meningiomas in the first two decades of life: a clinicopathological analysis of 87 patients. J Neurosurg 103 (Pediatrics 6 Suppl):489–95