Clinical features and long-term outcomes of pediatric spinal meningiomas

Pediatric spinal meningiomas are very rare. Most studies on pediatric spinal meningiomas are case reports with literature reviews. This study presented a surgical series of 14 pediatric patients with histologically proven sporadic spinal meningiomas, including 5 WHO grade II tumors. In this series, there were 9 male and 5 female patients with a mean age of 11.1 years. Seven tumors were located in the cervical spine, 5 in the thoracic spine, and 2 in the lumbar spine. Gross total resection (GTR) of the tumor with a well-demarcated dissection plane was achieved in 11 cases, subtotal resection was achieved in 2 cases, and partial resection was performed in 1 case. The symptoms were improved in 10 cases at the last follow-up and the current status of 2 patients worsened and 1 patient had no change compared to the preoperative presentation. One patient died of progressive tumor regrowth after partial resection and adjuvant radiotherapy. The postoperative follow-up magnetic resonance imaging showed tumor recurrence in one of the 11 GTR cases during the mean follow-up period of 72.5 months. Recurrence/regrowth of the residual tumors was observed in both the 2 STR cases. Although pediatric spinal meningiomas have a higher incidence of WHO grade II meningiomas, they are amenable to surgery if it is possible to achieve GTR. A good clinical outcome after GTR can be expected, even for WHO grade II meningiomas. Effect of adjuvant radiochemotherapy for controlling the tumors is still unclear and requires further investigation.