Pediatric Intracranial Meningiomas – Do They Differ from Their Counterparts in Adults?

Abstract

Aim: Meningiomas are very rare in children comprising only 0.44.1% of pediatric age tumors and only 1.5–1.8% of all intracranial neoplasms. We analyzed the clinical, pathological and management profile of these rare tumors and elucidated their differences from meningiomas in adults. Methods: From 1990 to 2005, 33 patients belonging to the pediatric age group with intracranial meningiomas were treated in NIMHANS. Results: There were 19 male and 14 female children. The duration of symptoms ranged from 1 to 60 months. The study had a mean follow-up of 23.4 months. The commonest presenting symptoms were headache (90.9%) and visual disturbances (51.5%). Three patients had associated neurofibromatosis. Calcification was noticed in 22% of the tumors. Intraventricular meningiomas were the commonest (24.2%). Gross total or near total resection was possible in 22 out of 33 patients. Nine patients had reversible postoperative motor deficits. Fibrous meningioma was the commonest histological subtype (24.2%). Five patients had atypical or anaplastic subtypes. Adjuvant radiotherapy was administered in 4 patients. Six patients had recurrences and underwent surgery. Ten patients required either staged procedures or multiple surgeries for the recurrence/residual tumors. Conclusion: Pediatric meningiomas are rare tumors and differ from those in adults by their male predominance, atypical locations, higher rates of malignant subtypes, recurrence and association with neurofibromatosis. Surgical management is challenging because of atypical location.

Pulmonary and pleural metastasis of intracranial anaplastic meningioma in a 3-year-old boy: A case report

“…However, some reports indicated that recurrence was very common for high-grade lesions, even following complete resection (1,7,8). Our case is consistent with these latter reports, as, although gross total excision of the tumor was possible, the tumor reappeared in the same location 2 months later.…”

Intraventricular Meningioma: Case Report and Literature Review

“…In a series of 675 adult meningiomas reported by Liu et al [7], only 3.7% were intraventricular. In 4 pediatric series of 98 combined cases, 19 (19.4%) were intraventricular [1,2,7,8]. Ney et al [9] reported an intraventricular meningioma that developed 23 years after cranial irradiation for acute lymphoblastic leukemia.…”

Pediatric Intraparenchymal Meningioma: Case Report and Comparative Review

“…There are also disparate epidemiological qualities between the two groups with less significant female preponderance within the pediatric population [1,4]. Some studies attribute a similar incidence to both sexes, while others suggest a higher incidence among male children [1,3,5,6]. The reason for this variation of incidence between pediatric and adult meningiomas is unknown but is perhaps suggestive of different pathophysiologies.…”

“…In the pediatric age group, this type of tumor is considerably rarer, making up roughly 2% of all pediatric CNS tumors [1,3]. A variant of the pediatric meningioma that is even more uncommon is that found to be completely intra-axial (intraparenchymal) and to arise without dural attachments.…”