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The importance of microsurgery in childhood meningioma: a case report
L E Kwee1, M L C van Veelen-Vincent, E M C Michiels
1Department of Pediatric Neurosurgery, Erasmus MC Sophia Children's Hospital, Dr. Molewaterplein 60, PO Box 2060, 3000 CB, Rotterdam, The Netherlands.
Introduction:
Although meningiomas are frequently diagnosed in adults, it is a rare (intracranial) tumor in the pediatric population, with an incidence of 0.06/100,000. The pathology and treatment of meningiomas in adulthood has been a topic of increasing investigation. So far, the treatment of pediatric meningiomas has been extrapolated from these results. The question remains, however, whether translation of adult meningioma data into the childhood population is legitimate.
Methods:
We present the case of a 3-year-old girl diagnosed with an intraventricular malignant meningioma and type 2 neurofibromatosis. She was operated on multiple times to achieve complete resection and received adjuvant chemotherapy. Since, she has been stable with no neurological sequelae and/or recurrence of the meningioma.
Conclusion:
Pediatric meningiomas are rare tumors and differ from their adult counterparts in various aspects. We believe that gross total resection of meningioma in the pediatric population, when possible, is the treatment of choice. In the event of a subtotal resection, repeat resection is recommended. Any adjuvant treatment with chemotherapy or radiation therapy should be carefully considered during multidisciplinary meetings.
Insights
Pediatric meningiomas are rare brain tumors that differ from adult types. Complete surgical resection is the preferred treatment for pediatric meningiomas, with further interventions considered if needed.
Area of Science:
- Pediatric neuro-oncology
- Neurosurgery
- Oncology
Background:
- Meningiomas are rare in children (0.06/100,000 incidence).
- Pediatric meningioma treatment is often extrapolated from adult data.
- The applicability of adult data to pediatric cases remains uncertain.
Observation:
- A case of a 3-year-old girl with intraventricular malignant meningioma and neurofibromatosis type 2 is presented.
- The patient underwent multiple surgeries for complete resection and received adjuvant chemotherapy.
- The patient remains stable with no neurological deficits or tumor recurrence.
Findings:
- Pediatric meningiomas exhibit distinct characteristics compared to adult meningiomas.
- Gross total resection is the recommended primary treatment for pediatric meningiomas.
- Repeat resection may be necessary after subtotal resection.
Implications:
- Surgical expertise is crucial for optimal outcomes in pediatric meningioma management.
- Adjuvant therapies (chemotherapy, radiation) require careful multidisciplinary consideration.
- Further research is needed to understand pediatric meningioma-specific treatment protocols.
