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Intracranial meningiomas in children: review of 29 cases
P Erdinçler1, G Lena, A C Sarioğlu
1Department of Neurosurgery, Cerrahpaşa Medical School, Istanbul University, Turkey.
Background:
Meningiomas are predominantly tumors of the fifth and sixth decades of life. Although rare in infancy and childhood, they represent an important field in pediatric neurosurgery.
Methods:
Twenty-nine children under 15 years of age with intracranial meningiomas were treated during the period 1968-1994 in the Department of Pediatric Neurosurgery in Marseille (23 cases) and in the Department of Neurosurgery of Cerrahpaşa Medical School in Istanbul (6 cases). These tumors represented 2.4% of all central nervous system (CNS) tumors in this age group.
Results:
There were 18 boys and 11 girls. Eighteen cases (62%) occurred between 10 and 15 years of age and two cases were infants. Twelve children (41%) had associated neurofibromatosis. Presenting symptoms were related to the tumor location. Thirty-one intracranial meningiomas were observed in these 29 children. Cerebral convexity was the most common location and 13% of the tumors had no dural attachment. Thirty-one tumors were operated on and total removal was achieved in 25 patients (86.2%). Five patients died, one during surgery. There was no mortality among the 17 children without neurofibromatosis. After a mean 6.5 year follow-up period, 13 patients (45%) are neurologically intact, 8 patients (27.5%) have a moderate disability, without evidence of tumor recurrence.
Conclusion:
Childhood meningiomas occur predominantly in males. Absence of dural attachment is more common in children than in adults. Childhood meningiomas have a low recurrence rate. They are frequently associated with neurofibromatosis; this is the most important factor influencing outcome.
Insights
Childhood meningiomas, though rare, are significant in pediatric neurosurgery. Neurofibromatosis is a key factor influencing outcomes in these pediatric brain tumors.
Area of Science:
- Pediatric Neurosurgery
- Neuro-oncology
- Tumor Biology
Background:
- Meningiomas are typically diagnosed in adults (5th-6th decades).
- Pediatric meningiomas are rare but crucial in pediatric neurosurgery.
- These tumors constitute 2.4% of CNS tumors in children.
Purpose of the Study:
- To analyze the characteristics and outcomes of intracranial meningiomas in children.
- To identify factors influencing prognosis in pediatric meningioma cases.
Main Methods:
- Retrospective analysis of 29 children (under 15) treated between 1968-1994.
- Data collected from pediatric neurosurgery departments in Marseille and Istanbul.
- Tumor characteristics, treatment, and follow-up data were reviewed.
Main Results:
- 18 boys and 11 girls diagnosed with 31 intracranial meningiomas.
- Neurofibromatosis was present in 41% of cases.
- Total tumor removal achieved in 86.2% of operated patients; 45% had excellent neurological outcomes at follow-up.
Conclusions:
- Childhood meningiomas are more common in males and frequently associated with neurofibromatosis.
- Absence of dural attachment is more common in pediatric meningiomas.
- Neurofibromatosis significantly impacts the outcome of childhood meningiomas, despite a low recurrence rate.