Pineal Region Meningioma in a Very Young Child

Area of Science:

• Pediatric neurosurgery
• Pediatric oncology
• Neuroradiology

Background:

• Meningiomas are uncommon in children, with pineal location being exceptionally rare, especially in those under five years old.
• This report details a rare case of a large pineal region meningioma in a very young child.
• The tumor presented atypically, mimicking common pathologies found at this intracranial site.

Observation:

• A 2.5-year-old child presented with signs of increased intracranial pressure.
• Magnetic Resonance Imaging (MRI) revealed a homogeneously enhancing pineal lesion with small cystic components.
• Cerebrospinal fluid analysis was initially performed to rule out germ cell tumors.

Findings:

• Surgical excision via the Krause approach was performed.
• The tumor lacked clear dural attachment and had a distinct arachnoid plane.
• Histopathological examination confirmed the diagnosis of meningioma.
• Complete tumor resection was achieved.

Implications:

• Meningiomas should be considered in the differential diagnosis of pediatric pineal region lesions.
• Early recognition and complete resection are associated with favorable outcomes in pediatric meningiomas.
• Preoperative and intraoperative assessments, including frozen section analysis, aid in differentiating pineal region tumors and guiding surgical strategy.