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Intraparenchymal meningioma in an infant--case report
I Kohama1, T Sohma, K Nunomura
1Department of Neurosurgery, Sapporo City General Hospital, Japan.
Insights
A pediatric intraparenchymal meningioma, a rare brain tumor, was successfully removed from a young girl. This case highlights that pediatric meningiomas often lack dural attachment, distinguishing them from adult forms.
Area of Science:
- Pediatric Neurosurgery
- Neuro-oncology
- Neuroradiology
Background:
- Intraparenchymal meningiomas are rare primary brain tumors, typically occurring in adults and arising from the dura mater.
- Pediatric meningiomas, while uncommon, can present differently, often lacking the characteristic dural attachment seen in adults.
Observation:
- A 1-year and 10-month-old girl presented with grand-mal seizures due to a left frontal lobe mass.
- Imaging revealed a well-defined, homogeneously enhancing intraparenchymal tumor.
- Surgical exploration confirmed a lesion fully embedded within the brain parenchyma, without dural or ventricular connection.
Findings:
- The tumor was completely excised, with feeding arteries identified from the middle cerebral artery.
- Histopathological analysis confirmed the diagnosis of a fibroblastic meningioma.
- The patient experienced an uneventful postoperative recovery and remained well at 2-year follow-up.
Implications:
- This case underscores that intraparenchymal meningiomas can occur in children and may present without dural attachment.
- The findings suggest that pediatric meningiomas might be more common than previously thought and require specific diagnostic considerations.
- Complete surgical resection is feasible and leads to favorable outcomes in pediatric intraparenchymal meningiomas.
Abstract:
A 1-year and 10-month-old girl presented with an intraparenchymal meningioma in the left frontal lobe manifesting as grand-mal seizures. Computed tomography and magnetic resonance images revealed a round, well-demarcated mass in the left frontal lobe which was homogeneously enhanced. Angiography showed the feeding arteries of the tumor from the middle cerebral artery. The preoperative diagnosis was an intraaxial tumor. At operation, the lesion was totally embedded in the frontal lobe without any connection to the overlying dura or the ventricular system. Some small feeders from the middle cerebral artery were coagulated and the tumor was totally removed. The histological diagnosis was fibroblastic meningioma. Her postoperative course was uneventful. She was doing well 2 years after surgery. Intraparenchymal meningiomas may be seen more frequently than expected in children. Absence of dural attachment is characteristic of pediatric meningiomas.