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Meningiomas in children: MR and histopathologic findings
C M Glasier1, M M Husain, W Chadduck
1Department of Radiology, Arkansas Children's Hospital, Little Rock 72202.
Purpose:
To present the MR and histopathologic findings in five children with meningiomas.
Methods:
Five children aged 3 months to 16 years with pathologically proved meningiomas underwent preoperative contrast enhanced MR. Tissue in four patients was sent for chromosomal analysis in addition to routine histopathologic studies.
Results:
All five tumors were extra-axial, two supratentorial and three in the posterior fossa. MR showed variable signal intensity on precontrast T1-weighted images. All of the tumors were hyperintense on proton density- and T2-weighted images and showed intense contrast enhancement. Histopathologic analysis showed two meningotheliomatous, one transitional, one chordoid, and one hemangiopericytic variant of meningioma. Chromosomal analysis showed deletions involving chromosome 22 in two of four tumors studied.
Conclusion:
Meningiomas in children have a higher incidence of posterior fossa location and different histologic types than seen in adults. MR showed the tumors in our patients to be extra-axial, hyperintense on proton density- and T2-weighted images with intense enhancement on postcontrast T1-weighted images. Chromosomal aberrations were noted in two patients.
Insights
Pediatric meningiomas, often extra-axial, present differently than adult tumors. Magnetic resonance (MR) imaging and histopathology reveal key diagnostic features in children with these brain tumors.
Area of Science:
- Pediatric neuro-oncology
- Neuroradiology
- Molecular genetics
Background:
- Meningiomas are uncommon in children but represent a significant portion of primary pediatric brain tumors.
- Understanding the unique characteristics of pediatric meningiomas is crucial for diagnosis and treatment planning.
Purpose of the Study:
- To detail the magnetic resonance (MR) imaging and histopathologic findings in a cohort of five pediatric patients diagnosed with meningiomas.
- To compare the findings in children with those typically observed in adult meningiomas.
Main Methods:
- Retrospective analysis of preoperative contrast-enhanced MR imaging in five children (3 months to 16 years) with pathologically confirmed meningiomas.
- Histopathologic examination of tumor tissue, including chromosomal analysis for chromosome 22 abnormalities in four patients.
Main Results:
- All five meningiomas were extra-axial, with two supratentorial and three in the posterior fossa.
- MR imaging demonstrated variable precontrast T1 signal, hyperintensity on proton density and T2-weighted images, and intense postcontrast enhancement.
- Histopathology revealed diverse subtypes, including meningotheliomatous, transitional, chordoid, and hemangiopericytic variants. Two of four tumors showed chromosome 22 deletions.
Conclusions:
- Pediatric meningiomas exhibit a predilection for posterior fossa location and a broader range of histologic subtypes compared to adult meningiomas.
- Characteristic MR imaging features include extra-axial location, specific signal intensities, and strong contrast enhancement.
- Chromosomal aberrations, particularly involving chromosome 22, are observed in a subset of pediatric meningiomas.