Top

Child's Nervous System

Published in:

01-04-2013 | Original Paper

Management of pediatric intracranial meningiomas: an analysis of 31 cases and review of literature

Authors: Kapu Ravindranath, M. C. Vasudevan, Anil Pande, Nigel Symss

Published in: Child's Nervous System | Issue 4/2013

Abstract

Objective

The purpose of this study is to understand the epidemiology, clinical features, behavior, and the prognostic factors that influence the outcome of intracranial meningiomas in children.

Methods

Thirty-one patients with age less than 18 years who underwent surgery for intracranial meningiomas during the period of at 1988–2012 at Voluntary Health Services Hospital, Chennai, India were studied. These formed 3.7 % of the total 831 cases of intracranial meningiomas operated at the institute.

Results

The study group included 22 (71 %) males and 9 (29 %) females. The mean age of presentation was 15 years, with the youngest being 9 months old. Two (6 %) had evidence of neurofibromatosis type 2 (NF2). The most common symptoms at presentation were seizures in 11 (35.5 %), weakness of limbs in 11 (35.5 %), and raised intracranial pressure in 10 (32 %). Convexity meningiomas were seen in 16 (51 %) and skull base in 15(49 %). Multiple meningiomas was seen in two (6 %) of the patients and intraventricular location was found in one patient (3 %). Two (6 %) had evidence of NF2. Gross total excision was achieved in 26 (83 %) and subtotal excision in 5 (17 %). WHO grade I was found in 20 (64 %) and higher grade was seen in 11 (36 %). The mean follow-up was 46.2 months. Recurrence was seen in 20 patients (64 %). In patients with higher grade or with recurrence resurgery and radiotherapy was given. Three (9 %) had multiple recurrences. On a mean follow-up of 46.2 months, 25 patients (81 %) were neurologically intact, 5 (16 %) were having moderated disability, and 1 (3 %) patient died.

Conclusions

Childhood meningiomas are uncommon lesions with a slight male predominance. They can have a varied clinical presentation. Higher grade is found more frequently compared with adults. Gross total resection is the goal and in higher grade meningiomas radiotherapy helps as a good adjuvant. Though the rate of recurrence is high, resurgery and radiotherapy gives a good outcome.

Alexiou GA, Mpairamidis E, Psarros A, Sfakianos G, Prodromou N (2008) Intracranial meningiomas in children: report of 8 cases. Pediatr Neurosurg 44(5):373–375PubMedCrossRef

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(7):406–416PubMedCrossRef

Arivazhagan A, India Devi B, Kolluri SV, Abraham RG, Sampath S, Chandramouli BA (2008) Pediatric intracranial meningiomas: do they differ from their counterparts in adults? Pediatr Neurosurg 44:43–48PubMedCrossRef

Artico M, Ferrante L, Cervoni L, Colonnese C, Fortuna A (1995) Pediatric cystic meningioma: report of three cases. Childs Nerv Syst 11:137–140PubMedCrossRef

Baumgartner JE, Sorenson JM (1996) Meningioma in the pediatric population. J Neurooncol 29(3):223–228PubMedCrossRef

Caroli E, Russillo M, Ferrante L (2006) Intracranial meningiomas in children: report of 27 new cases and critical analysis of 440 cases reported in the literature. J Child Neurol 21:31–36PubMedCrossRef

Castellano F, Ruggiero G (1953) Meningiomas of the posterior fossa. Acta Radiol Suppl 104:1–177PubMed

Chan RC, Thompson CB (1984) lntracranial meningiomas in childhood. Surg Neurol 21:319–322PubMedCrossRef

Chen HJ, Lui CG, Chen L (1986) Meningioma in anterior third ventricle in child. Childs Nerv Syst 2:160–161PubMedCrossRef

10.

Cooper M, Dohn DF (1974) Intracranial meningiomas in childhood. Cleve Clin Q 41:197–204PubMed

11.

Crouse SK, Berg BO (1972) Intracranial meningiomas in childhood and adolescence. Neurology 22:135–141PubMedCrossRef

12.

Cushing H, Eisenhardt L (1938) Meningiomas: their classification, regional behavior, life history, and surgical end results. Charles C Thomas, Springfield

13.

Davidson GS, Hope JK (1989) Meningeal tumors in childhood. Cancer 63:1205–1210PubMedCrossRef

14.

Deen HG Jr, Scheithauer BW, Ebersold MJ (1982) Clinical and pathological study of meningiomas of the first two decades of life. J Neurosurg 56:317–322PubMedCrossRef

15.

Rocco D, Di Renzo A (1999) Meningiomas in childhood. Crit Rev Neurosurg 9:180–188PubMedCrossRef

16.

Donnell MS, Meyer GA, Donegan WL (1979) Estrogen-receptor protein in intracranial meningiomas. J Neurosurg 50:499–502PubMedCrossRef

17.

Doty JR, Schut L, Bruce DA, Sutton LN (1987) Intracranial meningiomas in childhood and adolescence. Prog Exp Tumor Res 30:247–254PubMed

18.

Drake JM, Hendrick EB, Becker, LE, Chuang SH, Hoffman HJ, Humphreys RP (1985–1986) lntracranial meningiomas in children. Pediatr Neurosci 12:134–139

19.

Dziuk TW, Woo S, Butler EB, Thornby J, Grossman R, Dennis WS, Lu H, Carpenter LS, Chiu JK (1998) Malignant meningioma: an indication for initial aggressive surgery and adjuvant radiotherapy. J Neurooncol 37:177–188PubMedCrossRef

20.

Erdinçler P, Lena G, Sarioglu AC, Kuday C, Choux M (1998) Intracranial meningiomas in children: review of 29 cases. Surg Neurol 49:136–141PubMedCrossRef

21.

Ferrante L, Acqui M, Artico M, Mastronardi L, Rocchi G, Fortuna A (1989) Cerebral meningiomas in children. Childs Nerv Syst 5:83–86PubMedCrossRef

22.

Gao X, Zhang R, Mao Y, Wang Y (2009) Childhood and juvenile meningiomas. Childs Nerv Syst 25(12):1571–1580PubMedCrossRef

23.

Germano IM, Edwards MS, Davis RL, Schiffer D (1994) Intracranial meningiomas of the first two decades of life. J Neurosurg 80:447–453PubMedCrossRef

24.

Greene S, Nair N, Ojemann JG, Ellenbogen RG, Avellino AM (2008) Meningiomas in children. Pediatr Neurosurg 44:9–13PubMedCrossRef

25.

Hanel RA, Tatsui CE, Araujo JC, Grande CV, Antoniuk A, Gasparetto EL, Torres LF (2001) Meningiomas in pediatric patients: report of 2 cases. Arq Neuropsiquiatr 59:623–627PubMedCrossRef

26.

Herz DA, Shapiro K, Shulman K (1980) Intracranial meningiomas in infancy, childhood and adolescence. Rev Lit Childs Brain 7(1):43–56

27.

Huang PP, Doyle WK, Abbott IR (1993) Atypical meningioma of the third ventricle in a 6 year old boy. Neurosurgery 33:312–316PubMedCrossRef

28.

Im SH, Wang KC, Kim SK, Oh CW, Kim DG, Hong SK, Kim NR, Chi JG, Cho BK (2001) Children meningioma: unusual location, atypical radiological findings and favourable treatment outcome. Childs Nerv Syst 17:656–562PubMedCrossRef

29.

Jaaskelainen J (1986) Seemingly complete removal of histologically benign intracranial meningioma: late recurrence rat e and factors predicting recurrence in 657 patients. Surg Neurol 26:461–469PubMedCrossRef

30.

Kaplan SS, Ojemann JG, Park TS (2002) Pediatric sylvian fissure meningioma. Pediatr Neurosurg 36:275–276PubMedCrossRef

31.

Kobata H, Kondo A, Iwasaki K, Kusaka H, Ito H, Sawada S (1998) Chordoid meningioma in a child. J Neurosurg 88:319–323PubMedCrossRef

32.

Kohama I, Sohma T, Nunomura K, Igarashi K, Ishikawa A (1996) Intraparenchymal meningioma in an infant: a case report. Neurol Med Chir (Tokyo) 36:598–601CrossRef

33.

Kolluri VR, Reddy DR, Reddy PK, Naidu MR, Rao SB, Sumathi C (1987) Meningiomas in childhood. Childs Nerv Syst 3:271–273PubMedCrossRef

34.

Lakhdar F, Arkha Y, El Ouahabi A, Melhaoui A, Rifi L, Derraz S, El Khamlichi A (2012) Intracranial meningioma in children: different from adult forms? A series of 21 cases. Neurochirurgie 56(4):309–314CrossRef

35.

Leibel SA, Wara WM, Sheline GE, Townsend JJ, Boldrey EB (1976) The treatment of meningiomas in childhood. Cancer 37(6):2709–2712PubMedCrossRef

36.

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(2):112–117PubMedCrossRef

37.

Markwalder TM, Seiler R, Zava DT (1985) Antiestrogenic therapy of meningiomas: a pilot study. Surg Neurol 24:245–249PubMedCrossRef

38.

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 (Wien) 151(3):239–244CrossRef

39.

Merten DF, Gooding CA, Newton TH, Malamud N (1974) Meningioma of childhood and adolescence. J Pediatr 84:696–700PubMedCrossRef

40.

Molleston MC, Moran CJ, Roth KA, Rich KM (1994) Infantile meningiomas. Pediatr Neurosurg 21(3):195–200PubMedCrossRef

41.

Nakamura Y, Becker LE (1985) Meningeal tumors of infancy and childhood. Pediatr Pathol 3:341–358PubMedCrossRef

42.

Mehta N, Bhagwati S, Parulekar G (2009) Meningiomas in children: a study of 18 cases. J Pediatr Neurosci 4(2):61–65PubMedCrossRef

43.

Oka H, Kurata A, Kawano N, Saegusa H, Kobayashi I, Ohmomo T, Miyasaka Y, Fujii K (1998) Pre-operative superselective embolisation of meningiomas: indications and limitations. J Neurooncol 40:67–71PubMedCrossRef

44.

Palma L, Celli P, Franco C, Cervoni L, Cantore G (1997) Longterm prognosis for atypical and malignant meningiomas: a study of 71 surgical cases. J Neurosurg 86:793–800PubMedCrossRef

45.

Perry A, Dehner LP (2003) Meningeal tumors of childhood and infancy: an update and literature review. Brain Pathol 13:386–408PubMedCrossRef

46.

Pinto PS, Huisman TA, Ahn E, Jordan LC, Burger P, Cohen KJ, Patay Z, Tekes A (2011) Magnetic resonance imaging features of meningiomas in children and young adults: a retrospective analysis. J Neuroradiol 39(4):218–226PubMed

47.

Pravdenkova S, Al-Mefty O, Sawyer J, Husain M (2006) Progesterone and estrogen receptors: opposing prognostic indicators in meningioma. J Neurosurg 105:163–173PubMedCrossRef

48.

Probst EN, Grzyska U, Westphal M, Zeumer H (1999) Pre operative embolization of meningiomas with a fibrin glue preparation. AJNR Am J Neuroradiol 20:1695–1702PubMed

49.

Sandberg DI, Edgar MA, Resch L, Rutka JT, Becker LE, Souweidane MM (2001) MIB-1 staining index of pediatric meningiomas. Neurosurgery 48:590–597PubMedCrossRef

50.

Sano K, Wakai S, Ochiai C, Takakura K (1981) Characteristics of intracranial meningiomas in childhood. Childs Brain 8:98–106PubMed

51.

Santos MV, Furlanetti L, Valera ET, Brassesco MS, Tone LG, de Oliveira RS (2012) Pediatric meningiomas: a single-center experience with 15 consecutive cases and review of the literature. Childs Nerv Syst 28(11):1887–1896PubMedCrossRef

52.

Simpson D (1957) The recurrence of intracranial meningiomas after surgical treatment. J Neurol Neurosurg Psychiatry 20:22–39PubMedCrossRef

53.

Thuijs NB, Uitdehaag BM, Van Ouwerkerk WJ, van der Valk P, Vandertop WP, Peerdeman SM (2012) Pediatric meningiomas in The Netherlands 1974–2010: a descriptive epidemiological case study. Childs Nerv Syst 28(7):1009–1015PubMedCrossRef

54.

Wilson CB (1994) Meningiomas: genetics, malignancy, and the role of radiation in induction and treatment. The Richard C. Schneider Lecture. J Neurosurg 81:666–675PubMedCrossRef

55.

Yang K, Chen J, Jiang X (2000) Intracranial meningiomas in children. Chin J Clin Neurosurg 5:21–23

Title: Management of pediatric intracranial meningiomas: an analysis of 31 cases and review of literature
Authors: Kapu Ravindranath
M. C. Vasudevan
Anil Pande
Nigel Symss
Publication date: 01-04-2013
Publisher: Springer-Verlag
Published in: Child's Nervous System / Issue 4/2013
Print ISSN: 0256-7040
Electronic ISSN: 1433-0350
DOI: https://doi.org/10.1007/s00381-012-2010-7

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Management of pediatric intracranial meningiomas: an analysis of 31 cases and review of literature

Abstract

Objective

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Objective

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 4/2013

Operative management of idiopathic spinal intradural arachnoid cysts in children: a systematic review

Ping pong fractures: treatment using a new medical device

Urinary bladder perforation, intra-corporeal knotting, and per-urethral extrusion of ventriculoperitoneal shunt in a single patient: case report and review of literature

Response to bevacizumab, irinotecan, and temozolomide in children with relapsed medulloblastoma: a multi-institutional experience

Primary gliomatosis cerebri involving gray matter in pediatrics: a distinct entity? A multicenter study of 14 cases

Interactions between programmable shunt valves and the iPad 3 with Smart Cover