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Meningeal tumors of childhood
1Department of Pathology, Hospital for Sick Children, Toronto, Ontario, Canada.
Abstract:
Meningeal tumors occurring in a pediatric hospital over a period of 18 years were studied. The incidence of meningeal sarcomas was much lower than has been previously reported. A histologic subtype of meningiomas was found which has not previously been described. In these "sclerosing" tumors only a small portion of the lesion contained viable cells, most of which bore little resemblance to conventional meningothelial cells. The bulk of the lesions consisted of whorling collagen bundles produced by the tumor. All cases in which there was tumor invasion of the brain fell into this category. The prognosis for the sclerosing meningiomas was similar to conventional meningiomas, casting doubt on the value of brain invasion as a marker of malignancy in childhood meningiomas. The recognition of this histologic type may aid diagnosis, guide surgical management, and possibly make postoperative radiotherapy unnecessary.
Insights
A new "sclerosing" subtype of meningioma was identified in children, challenging the significance of brain invasion as a malignancy marker in pediatric meningiomas.
Area of Science:
- Pediatric Neurosurgery
- Surgical Pathology
- Oncology
Background:
- Meningeal tumors are rare in children.
- Previous studies have reported varying incidences of meningeal sarcomas and meningiomas.
- The prognostic significance of brain invasion in pediatric meningiomas requires further investigation.
Purpose of the Study:
- To investigate the incidence and characteristics of meningeal tumors in a pediatric hospital over 18 years.
- To describe a newly identified histologic subtype of meningioma.
- To evaluate the prognostic value of brain invasion in childhood meningiomas.
Main Methods:
- Retrospective review of pediatric meningeal tumors over an 18-year period.
- Histologic examination of tumor samples.
- Correlation of histologic findings with clinical data and patient outcomes.
Main Results:
- The incidence of meningeal sarcomas was lower than previously reported.
- A novel histologic subtype, "sclerosing" meningioma, was identified, characterized by collagen bundles and few viable cells.
- All cases with brain invasion were of the sclerosing subtype.
- Prognosis for sclerosing meningiomas was similar to conventional meningiomas, questioning brain invasion as a malignancy indicator.
Conclusions:
- The recognition of sclerosing meningiomas is crucial for accurate diagnosis and surgical planning in pediatric cases.
- Brain invasion may not be a reliable marker of malignancy in childhood meningiomas.
- This finding may influence the need for postoperative radiotherapy.