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Published on: June 28, 2024
Pediatric intraventricular meningioma: A series of six cases
Chinmaya Dash1, Ribhav Pasricha1, Hitesh Gurjar1
1Department of Neurosurgery, All Institute of Medical Sciences, New Delhi, India.
Objective:
Meningiomas in children is a rare occurrence. Primary intraventricular meningiomas (IVMs) are even rarer with reported incidence of 0.5%-5% of all meningiomas. The aim of the study was to describe the demographic profile, location, surgical approach, complications, and histopathology of six pediatric patients with IVM.
Materials And Methods:
We retrospectively analyzed all intraventricular tumors operated at our Institute from January 2010 till July 2015. Patients' clinical details and follow-up were obtained from hospital records and scans were obtained from picture archiving and communication system.
Results:
We found 6 pediatric patients (age ≤18 years) with histopathologically proven IVM. The mean age in this series was 14.6 years. Tumor was most commonly approached through the superior parietal lobule in this series. Gross total excision was achieved in all patients. The blood loss in the series was in the range of 600-2000 ml with a mean of 1100 ml. All were grade 1 meningioma on histopathological examination. Transitional meningioma was the most common histological subtype. None of the patients had a recurrence at last follow-up.
Conclusions:
Pediatric IVMs are rare tumors. They tend to have a male preponderance in contrast to adults which have a preference for females. Parietooccipital transcortical, transcallosal approach, middle/inferior temporal gyrus approach are the described techniques to tackle such tumors depending on the location of such tumors. Surgeons should watch out for massive blood loss during surgery, especially via the parietooccipital transcortical approach.
Insights
Pediatric intraventricular meningiomas (IVMs) are rare, with this study detailing six cases. All tumors were successfully removed, showing no recurrence, but surgeons must monitor for significant blood loss during procedures.
Area of Science:
- Neurosurgery
- Pediatric Oncology
- Neuropathology
Background:
- Intraventricular meningiomas (IVMs) are rare, particularly in pediatric patients, accounting for a small percentage of all meningiomas.
- This study focuses on the unique characteristics of IVMs in individuals under 18 years of age.
Purpose of the Study:
- To describe the demographic profile, tumor location, surgical techniques, and histopathological findings of pediatric IVMs.
- To analyze complications and outcomes associated with the surgical management of these rare tumors.
Main Methods:
- Retrospective analysis of pediatric patients (age ≤18 years) with histopathologically confirmed IVM operated between January 2010 and July 2015.
- Review of clinical details, follow-up data, and imaging from hospital records and picture archiving and communication systems.
Main Results:
- Six pediatric patients with IVM were identified, with a mean age of 14.6 years.
- The superior parietal lobule approach was most common; gross total excision was achieved in all cases.
- All identified tumors were World Health Organization (WHO) Grade 1, with transitional meningioma being the most frequent subtype. No recurrences were observed.
Conclusions:
- Pediatric IVMs exhibit a male predominance, contrasting with adult IVMs.
- Surgical approaches vary based on tumor location, including parietooccipital transcortical and transcallosal routes.
- Surgeons must be vigilant regarding potential for substantial intraoperative blood loss, especially with the parietooccipital transcortical approach.
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