Meningiomas in childhood

Kolluri, V. R. Sastry; Reddy, D. Raja; Reddy, P. Madhusudhana; Naidu, M.R.C.; Rao, S. Balaparameswara; Sumathi, C.

doi:10.1007/bf00271821

Cited by 41 publications

(18 citation statements)

References 21 publications

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“…Statistically, the role of radiotherapy has not been proven to be effective, but there has been a tendency towards a lower recurrence rate after postoperative radiotherapy 3) . On the other hand, some authors have suggested that radiotherapy should be performed only after partial resection or at recurrence 11,12) . In young children with clear cell meningioma, in particular, Carra et al 1) have suggested a reasonably aggressive …”

Section: Resultsmentioning

confidence: 99%

Non-Dura Based Intaspinal Clear Cell Meningioma

Choi

Cho

et al. 2011

J Korean Neurosurg Soc

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findings. The motor power of her lower limbs was normal, and rectal examination revealed normal anal tone.Magnetic resonance (MR) imaging showed a well-demarcated 1.5×1.9×2.9 cm sized mass lesion at L2-3. The mass was hypo-intense on T1-and T2-weighted images with homogeneous gadolinium enhancement. There was also a cystic lesion within the spinal cord on the cranial side of the mass at T12-L2. The cyst was isointense to the cerebrospinal fluid and was diagnosed to be tumor associated syrinx (Fig. 1). Myelography of the lumbar spine revealed obstruction of contrast flow due to the intradural mass. Operation was conducted with the presumptive diagnosis of intradural extramedullary meningioma. An L1-3 laminectomy and intradural exposure revealed a yellowish pink, well-encapsulated, elliptical mass of firm consistency. The tumor was found to be draped by and adhered to the nerve roots at its upper pole near the conus medullaris and cauda equina at its lower pole without dural attachment. However, the tumor was successfully dissected from the nerve roots and removed completely. The patient recovered uneventfully after the operation. The postoperative MR imaging showed no residual tumor with marked reduction of the syrinx. All of the patient's preoperative symptoms improved after surgery.The histology of the tumor showed patternless sheets of polygonal cells with clear glycogen-rich cytoplasm and small clusters of cells in a meningothelial pattern with whorl formation (Fig. 2). A Periodic acid-Schiff (PAS) stain showed a positive reaction in the cytoplasm of tumor cells containing glycogen (Fig. 3). Tumor cells were stained positive for vimentin (Fig. 4) and epithelial membrane antigen (EMA). These findings were compatible with the diagnosis of clear cell meningioma. Postoperatively, the patient's symptoms were dramatically alleviated. Ad- INTRODUCTIONClear cell meningioma is a very rare histological type of meningioma that is included in the World Health Organization (WHO) classification as a peculiar variant affecting younger patients 10,14,24,25) . Clear cell meningiomas have been reported in only 0.2% of meningioma cases and have a more aggressive and complicated course due to their histological nature and anatomical locations 25) . Most meningiomas are attached to the dura mater and very seldomly they grow without dural attachment. To the best of our knowledge, only several cases of intraspinal nondura based clear cell meningioma have been reported 2,5,17,19,20) . In this article, we present an unusual case of intraspinal clear cell meningioma characterized by the absence of dural attachment. CASE REPORTA 34-year-old female patient was admitted with complaints of pain in her lower limbs and both hips for 6 months and voiding difficulty for 1 year. She had also experienced numbness in her lower limbs. Her symptoms worsened over time. One year prior to admission, she visited a local obstetrics and gynecology clinics complaining voiding difficulty and was treated conservatively under the diagnosis of cystitis with...

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Section: Resultsmentioning

confidence: 99%

Non-Dura Based Intaspinal Clear Cell Meningioma

Choi

Cho

et al. 2011

J Korean Neurosurg Soc

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“…They comprise only 0.4–4.1% of all pediatric age tumors and only 1.5–1.8% of all intracranial neoplasms in children [1]. In the literature, large series of pediatric meningiomas are uncommon and only a few studies have attempted to analyze the characteristics of these neoplasms in children and the biological differences in comparison to the adult counterparts [1,2,3,4]. We retrospectively analyzed the clinical, pathological and management profile of these tumors.…”

Section: Introductionmentioning

confidence: 99%

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

et al. 2007

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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.

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“…Na criança parece haver inversão da relação entre os sexos, sendo o sexo masculino mais incidente segundo alguns autores 12 . A deformação da caixa craniana e as localizações intraventriculares parecem ser mais freqüentes e a dura máter parece ser menos envolvida que nos adultos [13][14][15] .…”

Section: Discussionunclassified

Extenso meningioma atípico na infância: relato de caso

Rondinelli¹,

Viana

Osório³

2003

Arq. Neuro-Psiquiatr.

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RESUMO -Meningiomas são raros na criança e pequeno número de casos foi publicado até hoje. Eles são tumores tipicamente indolentes, mas, podem apresentar comportamento mais agressivo na infância. A conduta ideal é a cirurgia com ressecção completa do tumor. Na impossibilidade da remoção cirúrgica completa do tumor, as opções de tratamento são reduzidas. Nosso objetivo é descrever um caso de meningioma atípico na infância em menina de três anos, e sua evolução. PALAVRAS-CHAVE: meningioma atípico, tumores meníngeos, meningiomas na infância.A large atypical meningioma in childhood: case report ABSTRACT -Meningiomas are rare in children and a small number of cases has been published. They are tumors typically indolent, but sometimes they show an extreme aggressive behavior. The gold standard of treatment is surgery with total remove of tumor. If the surgery is not possible to do, the options of treatment are few. We describe a case of an atipical meningioma in a 3 years-old girl.KEY WORDS: atypical meningioma, tumors of the meninges, childhood meningiomas. Meningiomas são, geralmente, tumores benignos de crescimento lento. Derivam das meninges cranoespinais e são relativamente freqüentes no adulto e potencialmente curáveis com a ressecção cirúr-gica completa, pois facilmente têm um plano de clivagem entre a área tumoral e o tecido cerebral normal, que favorece a cirurgia 1 . No adulto é descrito um pico de incidência entre os 50 e os 70 anos de idade, com predomínio nas pacientes do sexo feminino 2 . A extensão da ressecção cirúrgica influencia de maneira positiva o prognóstico dos pacientes portadores de meningioma 3 . Certamente o fator mais importante no prognóstico dos meningiomas é dado pela localização e conseqüentemente pela ressecabilidade da lesão 4 . Como terapia complementar após a cirurgia, podemos citar a radioterapia, utilizada após a ressecção parcial ou completa; esta modalidade parece aumentar as possibilidades de controle local da doença 5 . A sobrevida dos meningiomas benignos situa-se ao redor de 65 a 90% em 5 anos nos adultos. Os meningiomas mais agressivos, ao contrá-rio, parecem ter prognóstico mais sombrio. Em estudo retrospectivo publicado em 1990, um total de 38 pacientes portadores de meningiomas malignos, submetidos à cirurgia e à radioterapia, apresentaram sobrevida livre de doença de 25% em 5 anos 5 . A sobrevida de 5 anos em crianças é de 76% segundo Drake e colaboradores 6 . Nosso objetivo é descrever um caso de meningioma atípico na infância precoce, a extensão da lesão, a dificuldade diagnóstica e as modalidades terapêuticas utilizadas. CASOMenina de 3 anos de idade, com história clínica com duração aproximada de 5 meses, de protusão dos globos oculares e cefaléia intermitente. Ao exame neurológico inicial, mostrava estrabismo convergente, proptose bilateral com acentuada diminuição da acuidade visual e obstrução nasal. Sem alterações reflexas e de motricidade. Ressonância magnética (RM) evidenciou extensa massa intracraniana, com intensa captação de contraste. A neoplasia compromet...

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Meningiomas in childhood

Cited by 41 publications

References 21 publications

Non-Dura Based Intaspinal Clear Cell Meningioma

Non-Dura Based Intaspinal Clear Cell Meningioma

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

Extenso meningioma atípico na infância: relato de caso

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