Clinical Features and Treatment of Meningiomas in Children: Report of 12 Cases and Literature Review

Abstract

Objective: To study the clinical characteristics and treatment of meningiomas in children. Methods: One hundred and sixty-six meningiomas in children, including 12 cases treated in Qilu hospital and 8 series reported in the literature, were analyzed retrospectively on sex, age distribution, presenting symptoms, signs, radiological and pathological findings, treatment and prognosis. Results: The ratio of boys and girls was 2.3:1. The age ranged from 0.5 to 15 years (mean 9.9 years). Cranial nerve disorder (28%) and signs of chronic increased intracranial pressure such as headaches (62%), vomiting (53%) and papilledema (55%) were the most common symptoms. The most common location was the cerebral convexity (41%), followed by ventricles (15%), saddle areas (8%), cerebellopontine angles (8%), brain intraparenchyma (5%), parasagittal regions (4%), etc. Homogeneous density was observed in 62.3% of all cases, calcification in 14.8%, cystic components in 21.3% and intratumoral hemorrhage in 1.6%. On average, the epithelial and fibroblastic types of meningiomas took up 55% of the case, while the amount of malignant or atypical meningiomas averaged 9%. Complete tumor excision was achieved in 74%, and postoperative mortality was 3.3%. Conclusions: Compared with meningiomas in adults, meningiomas in children occur predominantly in males with a lower incidence rate of epilepsy, and are frequently associated with multiple neurofibromatosis. Meningiomas in children have a poorer prognosis than those in adults. Degree of the first tumor resection, tumor location, pathological grade and association with neurofibromatosis are the most important factors influencing the patients’ prognoses.

Predicting postoperative hydrocephalus in 227 patients with skull base meningioma

“…Our overall incidence of hydrocephalus, at 5.9%, is in concordance with other studies showing incidence rates ranging from 2% to 13%. 3,6,12,21 The wide range reported in the literature thus far is most likely due to the different localizations of the meningiomas included in these studies. For instance, Duong et al 6 showed a postoperative hydrocephalus incidence rate of 8% for meningiomas located in the skull base region, and Boviatsis et al 3 described a rate of 6.9% for supratentorial meningiomas.…”

“…3,4,6,12,14,15,19 True postoperative hydrocephalus needs to be distinguished from the occurrence of transient obstructive hydrocephalus, which is most frequently due to the mass effect of the meningioma present before surgery. 6 Although causes and factors influencing the occurrence of true postoperative hydrocephalus are still unknown, our data demonstrate that this disorder is more likely to occur after meningioma extirpation in the skull base region compared with other locations, as has been suggested by others.…”

Giant Atypical Intraventricular Meningioma in a Child

“…These tumors are usually large in size and can cause a variety of symptoms according to their localization [1,2]. In a review of 166 pediatric meningioma cases, intraventricular meningiomas constituted 15% of cases followed by saddle areas, cerebellopontine angle, brain intraparenchyma, and parasagittal regions [4]. These tumors are often associated with neurofibromatosis type II [5].…”

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.…”