Primary intraventricular meningiomas in children—experience of two cases with review of literature

Abstract

Meningiomas are rare in the pediatric age group, more so in the intraventricular location. They arise in the lateral ventricles from the arachnoid cells contained within the choroid plexus, in the third ventricle from the velum interpositum and in the fourth ventricle from the choroids. These tumors are usually large and have an aggressive behaviour. Surgical management of intra-ventricular meningiomas is challenging because of their deep location, large size at presentation and increased vascularity. The authors report two such cases who presented with symptoms of raised intra cranial pressure and on evaluation were found to have associated hydrocephalus. Both these patients underwent surgical excision of the tumour by frontal transcortical approach and histopathology report confirmed transitional meningioma in them. Only twenty seven cases of intraventricular meningiomas in children have been reported till date. Their definitive treatment is surgery alone and total excision of the tumor is curative. Possibility of neurofibromatosis as a differential should also be considered in their management.

Pediatric Cerebral Meningioma: A Single-Center Study with 10 Children Not Associated with Neurofibromatosis Type 2 and Literature Review

“…In this literature review, 13 PM patients from 7 authors (Table 3), representing 13% of a total of 99 patients from 16 out of 32 authors who provided information about the history of NF2, suggest a lower concomitant occurrence rate of NF2 in pediatric patients with cerebral meningioma as compared to some single research series such as by Santos et al [7] with 9 patients, Muley et al [6] with 2 patients, and Chohan et al [29] with only 1 patient, suggesting an NF2 rate of 33%, 50%, and 100%, respectively.…”

“…Intraventricular meningiomas arise from arachnoid cap cells embedded in the choroid plexus or from the tela choroidea and do not present any dural attachments [3][4][5]. Although intraventricular meningiomas are relatively frequent in pediatric patients, they are extremely rare in the third ventricle [6]. Studies have shown male predominance [1,[7][8][9].…”

“…Pediatric cerebral meningiomas are associated with neurofibromatosis type 2 (NF2), and some small series have reported occurrences as high as 50% [6] and 33% [7]. Cases of PM that occur after oncological treatment during childhood with several types of radiation-induced tumors have been reported in pediatric patients.…”

Pediatric Intraventricular Meningiomas: Clinical Cases, Aspects of Surgical Technique and Complications

“…Важно отметить, что симптомы заболевания являются неспецифичными и, как правило, развиваются постепенно. Обычно заболевание манифестирует развитием общемозговой симптоматики, связанной с повышением внутричерепного давления и характерными для этого изменениями на глазном дне [9,14]. Вырастая до значительных размеров, опухоль может оказывать локальное воздействие, с которым связано появление очаговой неврологической симптоматики, развитие гемипареза, судорог и другой симптоматики.…”

“…Менингиомы бокового желудочка составляют 0,5-4,5% всех внутричерепных менингиом. Внутри желудочков опухоли возникают из арахноидальных клеток, имеющихся в сосудистом сплетении желудочков головного мозга, а также в сосудистой основе полости промежуточного паруса [14,20]. Поэтому они чаще расположены в области треугольника бокового желудочка или tela choroidea четвертого желудочка [1].…”