Pediatric Intraparenchymal Meningioma: Case Report and Comparative Review

Abstract

Intra-axial (intraparenchymal) meningiomas are an extremely rare pathology with only dozens of cases reported. In children, the unusual characteristics of intraparenchymal meningiomas can easily create an atypical preoperative differential. The authors present the case of an otherwise healthy 14-year-old girl presenting with new-onset seizures and an intracranial lesion upon investigation. CT and MRI revealed a lesion both cystic and calcified in nature, residing completely within the brain parenchyma. Upon operative examination, the mass was found to be completely surrounded by cortex and to be of two disparate consistencies. Pathological analysis revealed the mass to be a meningioma. Despite the rarity in children, meningiomas must be kept on the differential for cystic, calcified lesions. The differential diagnosis based on imaging as well as the operative strategy taken are further discussed. In addition, the authors review the current understanding of pediatric meningiomas as compared with adult meningiomas.

A Multimodal Approach to the Treatment of Intraparenchymal Meningioma in a 7-Year-Old Boy: A Case Report

“…Intraparenchymal meningiomas are very rare; only 26 cases have been reported in patients younger than 20 years from 1954 until August 2016 [8], and the radiological aspect of intraparenchymal meningiomas is often atypical [1,2,[9][10][11]. Due to these reasons, we report the case of a right parietal WHO grade II meningioma that was thought to be a diffuse astrocytoma, a supratentorial ependymoma, or an ependymoblastoma based on radiological features and clinical history.…”

“…From 1954 until August 2016, only 26 cases have been reported in patients younger than 20 years [8]. Intraparenchymal meningiomas may be difficult to diagnose prior to a surgical intervention and pathological analysis due to their rarity and their atypical radiological presentation [1,2,[9][10][11]. In this article, the authors describe the case of a right parietal cortical meningioma without dural attachment, mimicking an intra-axial lesion, in a 7-year-old, left-handed boy.…”

Giant pediatric intraventricular meningioma: Case report and review of literature

“…[3] In another sharp contrast with the adults, meningiomas in the pediatric population are more common in males. [14] This is probably due to the absence of effect of sex hormone on steroid receptors. A significantly higher proportion (up to 40%) of these tumors is associated with neurofibromatosis.…”

Intraparenchymal Meningioma

“…Meningiomas by definition are benign tumors dependent on the cerebral meninges, specifically on the arachnoid or meningothelial cells [1][2][3][4], showing extra-axial location [3]. They constitute one of the most common primary neoplasms of the central nervous system, taking the first or second place in frequency at the intracranial level [5].…”

“…They constitute one of the most common primary neoplasms of the central nervous system, taking the first or second place in frequency at the intracranial level [5]. Sometimes they have an atypical presentation that lacks dural adhesion [1][2][3]6], so much so that it has been rarely reported in the literature [4,5,7,8].…”