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Posterior fossa clear cell meningioma without dural attachment in a child
Pablo Miranda1, Juan Antonio Simal, Manuel Vila
1Department of Neurosurgery, Division of Pediatric Neurosurgery, Hospital Universitario Infantil La Fe, Avda Campanar s/n., 46009 Valencia, Spain. mirandalloret@gmail.com
Introduction:
Meningiomas are relatively uncommon in childhood. They represent 1% to 2% of all intracranial tumours of infancy and childhood and 1.5% to 1.8% of all intracranial meningiomas. Occasionally, meningiomas may develop without dural attachment. Clear cell meningioma is a histological distinctive uncommon variant of meningioma that may behave aggressively with local recurrence and progression as well as cerebrospinal fluid-borne metastasis. Meningiomas near the craniocervical junction represent challenging tumours, requiring special considerations because of the vicinity of the medulla oblongata, the lower cranial nerves and the vertebral artery.
Case Report:
In this study, the authors present a rare case of posterior fossa clear cell meningioma without dural attachment in a child with severe brainstem and cervical spinal cord displacement and discuss the clinical and radiological features as well as treatment considerations.
Insights
Pediatric meningiomas are rare, especially clear cell types without dural attachment. This case highlights a challenging posterior fossa tumor in a child, emphasizing diagnostic and treatment considerations.
Area of Science:
- Pediatric neurosurgery
- Neuro-oncology
- Craniovertebral junction tumors
Background:
- Meningiomas are rare pediatric intracranial tumors, accounting for 1-2% of childhood brain tumors.
- Clear cell meningioma is an uncommon, aggressive histological variant.
- Tumors near the craniocervical junction pose unique surgical challenges due to critical nearby structures.
Observation:
- A rare case of a pediatric posterior fossa clear cell meningioma without dural attachment is presented.
- The tumor caused significant displacement of the brainstem and cervical spinal cord.
- Clinical and radiological features of this rare presentation were analyzed.
Findings:
- Clear cell meningiomas, though uncommon, can exhibit aggressive behavior, including recurrence and metastasis.
- Lack of dural attachment in meningiomas is unusual.
- Posterior fossa location with craniocervical involvement necessitates careful surgical planning.
Implications:
- This case underscores the importance of considering rare meningioma variants in pediatric posterior fossa masses.
- Accurate diagnosis and tailored treatment strategies are crucial for managing aggressive pediatric meningiomas.
- Further research into the behavior and optimal management of non-dural-attached clear cell meningiomas is warranted.
