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Clinical features and long-term outcomes of pediatric meningiomas
Jingdian Liu1, Kai Zhao1, Junwen Wang2
1Department of Neurosurgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.
Insights
Pediatric meningiomas are rare brain tumors in children, with higher-grade tumors more common than in adults. Adjuvant radiotherapy may improve outcomes for malignant pediatric meningiomas.
Area of Science:
- Pediatric neuro-oncology
- Neurosurgery
- Pathology
Background:
- Pediatric meningiomas are uncommon tumors with distinct clinical and pathological features compared to adult counterparts.
- Understanding their behavior in children is crucial for effective management.
Purpose of the Study:
- To analyze a 15-year experience with pediatric meningiomas.
- To evaluate clinical characteristics, pathological findings, and prognostic factors in children diagnosed with meningiomas.
Main Methods:
- Retrospective analysis of 40 children (age ≤ 15 years) diagnosed with meningiomas.
- Data collected included clinical presentation, histopathology, tumor location, treatment, and follow-up outcomes.
Main Results:
- The average age at diagnosis was 10.78 years. High-grade meningiomas (WHO grade III) accounted for 33.3% of cases.
- Gross total resection (GTR) was achieved in 82.5% of patients. Tumor recurrence occurred in 22.5% of cases.
- WHO grade III meningiomas were linked to poorer prognosis. Adjuvant radiotherapy showed potential benefit.
Conclusions:
- Pediatric meningiomas exhibit a higher incidence of high-grade tumors compared to adults, particularly in younger children.
- Tumor location influences grade, with skull base and parasagittal/falx sites more commonly associated with low-grade tumors.
- Adjuvant radiotherapy may be a beneficial treatment strategy for malignant pediatric meningiomas, improving prognosis.
Objective:
Pediatric meningiomas are relatively rare and have atypical clinical features compared to adults. The purpose of this work is to report our 15-year experience in the management of pediatric meningiomas and assess their clinical characteristics, pathological features, and prognostic factors.
Methods:
A total of 40 children (age ≤ 15 years) who were diagnosed as pediatric meningiomas were enrolled in this study. Patient information including clinical presentation, gender, age at time of diagnosis, histopathological features, tumor location, tumor volume, treatment methods, and follow-up data were extracted and analyzed.
Results:
The mean age at diagnosis was 10.78 ± 3.50 years (range 2-15 years) in 40 patients with a male to female ratio of 1:1.11. Headache, epilepsy, visual disturbance, and limb weakness are common clinical manifestations. Two patients had multiple intracranial meningiomas. Fourteen (33.3%) of pediatric meningiomas were high grade meningiomas. Seven patients (17.5%) were treated with STR, while GTR was achieved in 33 patients (82.5%). The mean follow-up period was 82.1 months (range 9-173 months). Recurrence occurred in 9 patients (22.5%), and 5 patients (12.5%) passed away.
Conclusion:
The incidence of pediatric meningiomas increases with advancing age. In pediatric patients, the percentage of high-grade tumors is higher than adults. Younger children were more likely to have high-grade meningiomas, while patients with tumors located in skull base or parasagittal/falx tend to have low-grade meningiomas. The WHO grade III meningiomas were significantly correlated with poor prognosis. Adjuvant radiotherapy after surgery can improve prognosis and may be a potential treatment strategy in children with malignant meningiomas.
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