Abstract
Objective
The goal of this study was to determine the epidemiology, clinical presentation, associated factors, pathological features, and treatment outcome of pediatric meningiomas in a single-center institution.
Methods
Clinical data of 15 patients under 18 years of age operated on for meningiomas from January 1994 to December 2010 were reviewed.
Results
The study group included nine males and six females (mean age of 13 years at surgery). The most common symptoms at presentation were headaches in 6 out of 15 (40 %), raised intracranial pressure in 3 out of 15 (20 %), and seizures in 3 out of 15 (20 %). Sole operated tumors were found in 12 out of 15 (80 %), whose location is as follows: parasagittal in 4 out of 12 (33.3 %), 2 in the convexity (16.6 %), 2 at the skull base (16.6 %), and 4 in other sites (33.3 %). Six children presented with radiation-induced (RT) meningiomas and five had evidence of neurofibromatosis type 2 (NF2). Three patients had multiple meningiomas (all of them had NF2). Simpson’s grade I excision was achieved in 12 out of 15 (80 %). On histopathology, 11 out of 15 (73.3 %) were grade I and 4 out of 15 (26.6 %) were grade II (all of them atypical). Five tumors (33.3 %) recurred, four of which had RT or NF2. During the mean follow-up period of 5 years, 12 out of 15 (80 %) had a good outcome (GOS = 5).
Conclusions
Childhood meningiomas are uncommon lesions with a slight male predominance. Absence of large series with long follow-up precludes any definite conclusions on the clinical course and outcome of these tumors. Associated factors (such as RT and NF2), location, and extent of excision appear to be more important than histopathological grade in predicting outcome.
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References
Alexiou GA, Mpairamidis E, Psarros A, Sfakianos G, Prodromou N (2008) Intracranial meningiomas in children: report of 8 cases. Pediatr Neurosurg 44:373–75
Al-Mefty O, Topsakal C, Pravdenkova S, Sawyer JR, Harrison MJ (2004) Radiation-induced meningiomas: clinical, pathological, cytokinetic, and cytogenetic characteristics. J Neurosurg 100:1002–13
Amirjamshidi A, Mehrazin M, Abbassioun K (2000) Meningiomas of the central nervous system occurring below the age of 17: report of 24 cases not associated with neurofibromatosis and review of literature. Childs Nerv Syst 16:406–16
Arivazhagan A, Devi BI, Kolluri SV, Abraham RG, Sampath S, Chandramouli BA (2008) Pediatric intracranial meningiomas—do they differ from their counterparts in adults? Pediatr Neurosurg 44:43–48
Brassesco MS, Valera ET, Neder L, Castro-Gamero AM, de Oliveira FM, Santos AC, Scrideli CA, Oliveira RS, Machado HR, Tone LG (2009) Childhood radiation-associated atypical meningioma with novel complex rearrangements involving chromosomes 1 and 12. Neuropathology 29:585–90
Choux M, Lena G, Genitoro L, Azambuja N, Cunha C, De-chambenoit G (1991) Meningiomas in children. In: Schmidek HH (ed) Meningiomas and their surgical management. WB Saunders, Philadelphia, pp 93–102
Cushing H, Eisenhardt L (1938) Serial enumeration of meningiomas. In: Thomas CC, (ed) Meningiomas: their classification, regional behaviour, life history, and surgical end results. Classics of Neurology & Neurosurgery Library, Springfield, IL pp 56–73
Davidson GS, Hope JK (1989) Meningeal tumors of childhood. Cancer 63:1205–10
Deen HG, Scheithauer BW, Ebersold MJ (1982) Clinical and pathological study of meningiomas of the first two decades of life. J Neurosurg 56:317–322
Di Rocco C, Di Rienzo A (1999) Meningiomas in childhood. Crit Rev Neurosurg 9:180–88
Erdinçler P, Lena G, Sarioglu AC, Kuday C, Choux M (1998) Intracranial meningiomas in children: review of 29 cases. Surg Neurol 49:136–140, discussion 140–131
Evans DGR, Watson C, King A, Wallace AJ, Baser ME (2005) Multiple meningiomas: differential involvement of the NF2 gene in children and adults. J Med Genet 42:45–48
Ferrante L, Acqui M, Artico M, Mastronardi L, Rocchi G, Fortuna A (1989) Cerebral meningiomas in children. Childs Nerv Syst 5:83–86
Jaiswal S, Vij M, Mehrotra A, Jaiswal AK, Srivastava AK, Behari S (2011) A clinicopathological and neuroradiological study of paediatric meningioma from a single centre. J Clin Neurosci 18:1084–9
Gao X, Zhang R, Mao Y, Wang Y (2009) Childhood and juvenile meningiomas. Childs Nerv Syst 25:1571–80
Galloway TJ, Indelicato DJ, Amdur RJ, Swanson EL, Morris CG, Marcus RB (2011) Favorable outcomes of pediatric patients treated with radiotherapy to the central nervous system who develop radiation-induced meningiomas. Int J Radiat Oncol Biol Phys 79:117–20
Germano IM, Edwards M, Davis RL, Schiffer DJ (1994) Intracranial meningiomas of the first two decades of life. J Neurosurg 80:447–453
Greene S, Nair N, Ojemann JG, Ellenbogen RG, Avellino AM (2008) Meningiomas in children. Pediatr Neurosurg 44:9–13
Harrison MJ, Wolfe DE, Lau TS, Mitnick RJ, Sachdev VP (1991) Radiation-induced meningiomas: experience at the Mount Sinai Hospital and review of the literature. J Neurosurg 75:564–74
Im SH, Wang KC, Kim SK, Oh CW, Kim DG, Hong SK, Kim NR, Chi JG, Cho BK (2001) Childhood meningioma: unusual location, atypical radiological findings, and favorable treatment outcome. Childs Nerv Syst 17:656–62
Kotecha RS, Junckerstorff RC, Lee S, Cole CH, Gottardo NG (2011) Pediatric meningioma: current approaches and future direction. J Neurooncol 104:1–10
Kotecha RS, Pascoe EM, Rushing EJ, Rorke-Adams LB, Zwerdling T, Gao X, Li X, Greene S, Amirjamshidi A, Kim SK, Lima MA, Hung PC, Lakhdar F, Mehta N, Liu Y, Devi BI, Sudhir BJ, Lund-Johansen M, Gjerris F, Cole CH, Gottardo NG (2011) Meningiomas in children and adolescents: a meta-analysis of individual patient data. Lancet Oncol 12:1229–39
Lakhdar F, Arkha Y, El Ouahabi A, Melhaoui A, Rifi L, Derraz S, El Khamlichi A (2010) Intracranial meningioma in children: different from adult forms? A series of 21 cases. Neurochirurgie 56:309–14
Li X, Zhao J (2009) Intracranial meningiomas of childhood and adolescence: report of 34 cases with follow-up. Childs Nerv Syst 25:1411–17
Lillehei KO, Donson AM, Kleinschmidt-DeMasters BK (2008) Radiation-induced meningiomas: clinical, cytogenetic and microarray features. Acta Neuropathol 116:289–301
Liu M, Wei Y, Liu Y, Zhu S, Li X (2006) Intraventricular meningiomas: a report of 25 cases. Neurosurg Rev 29:36–40
Liu Y, Li F, Zhu S, Liu M, Wu C (2008) Clinical features and treatment of meningiomas in children: report of 12 cases and literature review. Pediatr Neurosurg 44:112–17
Lund-Johansen M, Scheie D, Muller T, Lundar T, Helseth E (2001) Neurosurgical treatment of meningiomas in children and young adults. Childs Nerv Syst 17:719–23
Mallucci CL, Parkes SE, Barber P, Powell J, Stevens MCG, Walsh AR, Hockley AD (1996) Paediatric meningeal tumours. Childs Nerv Syst 12:582–89
Maranhão-Filho P, Campos JC, Lima MA (2008) Intracranial meningiomas in children: ten-year experience. Pediatr Neurol 39:415–17
Mehta N, Bhagwati S, Parulekar G (2009) Meningiomas in children: a study of 18 cases. J Pediatr Neurosci 4:61–65
Menon G, Nair S, Sudhir J, Rao BR, Mathew A, Bahuleyan B (2009) Childhood and adolescent meningiomas: a report of 38 cases and review of literature. Acta Neurochir 151:239–44
Müller P, Henn W, Niedermayer I, Ketter R, Feiden W, Steudel WI, Zang KD, Steilen-Gimbel H (1999) Deletion of chromosome 1p and loss of expression of alkaline phosphatase indicate progression of meningiomas. Clin Cancer Res 5:3569–77
Nowell PC (1976) The clonal evolution of tumor cell populations. Science 194:23–8
Perry A, Dehner LP (2003) Meningeal tumours of childhood and infancy. An update and literature review. Brain Pathol 13:386–408
Perry A, Giannini C, Raghavan R, Scheithauer BW, Banerjee R, Margraf L, Bowers DC, Lytle RA, Newsham IF, Gutmann DH (2001) Aggressive phenotypic and genotypic features in paediatric and NF2-associated meningiomas: a clinico-pathologic study of 53 cases. J Neuropathol Exp Neurol 60:994–1003
Pettorini BL, Park YS, Caldarelli M, Massimi L, Tamburrini G, Di Rocco C (2008) Radiation-induced brain tumours after central nervous system irradiation in childhood: a review. Childs Nerv Syst 24:793–805
Raaschou-Nielsen O, Sørensen M, Carstensen H, Jensen T, Bernhardtsen T, Gjerris F, Schmiegelow K (2006) Increasing incidence of childhood tumours of the central nervous system in Denmark, 1980–1996. Br J Cancer 95:416–22
Rochat P, Johannesen H, Gjerris F (2004) Long term follow up of children with meningiomas in Denmark 1935–1984. J Neurosurg 100(Pediatrics 2 Suppl):179–182
Rushing EJ, Olsen C, Mena H, Rueda ME, Lee YS, Keating RF, Packer RJ, Santi M (2005) Central nervous system meningiomas in the first two decades of life: a clinicopathological analysis of 87 patients. J Neurosurg 103(Pediatrics 6 Suppl):489–95
Salvati M, Cervoni L, Puzzilli F, Bristot R, Delfini R, Gagliardi FM (1997) High-dose radiation-induced meningiomas. Surg Neurol 47:435–42
Shoshan Y, Chernova O, Juen SS, Somerville RP, Israel Z, Barnett GH, Cowell JK (2000) Radiation-induced meningioma: a distinct molecular genetic pattern? J Neuropathol Exp Neurol 59:614–20
Simpson D (1957) The Recurrence of intracranial meningiomas after surgical treatment. J Neurol Neurosurg Psychiat 20:22–39
Teixidor P, Guillén A, Cruz O, Costa JM (2008) Intracranial meningiomas in children: report of 10 cases. Neurocirugia 19:434–39
Traunecker H, Mallucci C, Grundy R, Pizer B, Saran F (2008) Children’s Cancer and Leukaemia Group (CCLG): guidelines for the management of intracranial meningioma in children and young people. Br J Neurosurg 22:13–25
Tufan K, Dogulu F, Kurt G, Emmez H, Ceviker N, Baykaner MK (2005) Intracranial meningiomas of childhood and adolescence. Pediatr Neurosurg 41:1–7
Turgut M, Ozcan O, Bertan V (1997) Meningiomas in childhood and adolescence: a report of 13 cases and review of literature. Br J Neurosurg 11:501–507
Umansky F, Shoshan Y, Rosenthal G, Fraifeld S, Spektor S (2008) Radiation-induced meningioma. Neurosurg Focus 24:E7
Vinchon M, Leblond P, Caron S, Delestret I, Baroncini M, Coche B (2011) Radiation-induced tumors in children irradiated for brain tumor: a longitudinal study. Childs Nerv Syst 27:445–53
Yoon HK, Kim SS, Kim IO, Na DG, Byun HS, Shin HJ, Han BK (1999) MRI of primary meningeal tumours in children. Neuroradiology 41:512–6
Zwerdling T, Dothage J (2002) Meningiomas in children and adolescents. J Pediatr Hematol/Oncol 24:199–204
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Santos, M.V., Furlanetti, L., Valera, E.T. et al. Pediatric meningiomas: a single-center experience with 15 consecutive cases and review of the literature. Childs Nerv Syst 28, 1887–1896 (2012). https://doi.org/10.1007/s00381-012-1823-8
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DOI: https://doi.org/10.1007/s00381-012-1823-8