Intracranial meningioma in children: different from adult forms? A series of 21 cases.
OBJECTIVE
Intracranial meningiomas are very rare in children, comprising only 0.4 to 4.1% of pediatric tumors and only 1.5 to 1.8% to all intracranial meningiomas. The goal of this study of pediatric meningiomas was to establish their epidemiological profile as well as their clinical and radiological features, to assess the long-term outcome, and compare this result with adult meningioma.


METHODS
We conducted a retrospective study from June 1983 to June 2007; during this period 521 patients underwent surgery for primary meningioma at the Rabat Hospital, Department of Neurosurgery. Twenty-one patients were under 16 years of age (4%). The clinical charts and imaging data were reviewed.


RESULTS
The mean age was 10.3 years (range: 2 to 16 years), with 13 boys and eight girls. In one patient a neurofibromatosis was associated. The mean delay to diagnosis was 4.6 months (range: 1 to 12 months). The most common clinical sign was raised intracranial pressure (90%). Of the meningiomas diagnosed, 47% were convexity meningiomas while 24% were parasagittal and 19% were skull-base meningiomas; in two cases (9.5%) the location was intraventricular. The mean tumor diameter was 6.6 cm (range: 3 to 10 cm). A large cystic component was found in 24% of the cases. Surgery achieved a Simpson grade I resection in 47%; 62% of the tumors were grade I and 24% were grade II based on World Health Organization pathological classification. The mean follow-up period was 33 months (range: 6 to 120 months). The recurrence rate was 33%.


CONCLUSIONS
Pediatric meningiomas are larger than those found in the adult population; there is a male predominance with high incidence of a cystic component and high-grade meningiomas, thus explaining the increased recurrence rate despite the multimodal treatment.
Lakhdar
F
F
Department of Neurosurgery, hôpital des Spécialités, Mohamed Vth University School of Medicine, Rabat Institute, BP 6444, 10100 Rabat, Morocco. lakhdar.faycal@gmail.com
Arkha
Y
Y
El Ouahabi
A
A
Melhaoui
A
A
Rifi
L
L
Derraz
S
S
El Khamlichi
A
A
D000293:Adolescent; D000375:Aging / Q000473:pathology*; D002533:Cerebral Angiography; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008579:Meningioma / Q000453:epidemiology / Q000473:pathology* / Q000601:surgery; D019635:Neurosurgical Procedures; D012189:Retrospective Studies; D012737:Sex Factors; D015173:Supratentorial Neoplasms / Q000453:epidemiology / Q000473:pathology* / Q000601:surgery; D016896:Treatment Outcome