title: Pediatric meningiomas in The Netherlands 1974-2010: a descriptive epidemiological case study.
abstract: OBJECTIVE
  The purpose of this study was to review the epidemiology and the clinical, radiological, pathological, and follow-up data of all surgically treated pediatric meningiomas during the last 35 years in The Netherlands.
  
  
  METHODS
  Patients were identified in the Pathological and Anatomical Nationwide Computerized Archive database, the nationwide network and registry of histopathology and cytopathology in The Netherlands. Pediatric patients of 18 years or younger at first operation in 1974-2009 with the diagnosis meningioma were included. Clinical records, follow-up data, radiological findings, operative reports, and pathological examinations were reviewed.
  
  
  RESULTS
  In total, 72 patients (39 boys) were identified. The incidence of operated meningiomas in the Dutch pediatric population is 1:1,767,715 children per year. Median age at diagnosis was 13 years (range 0-18 years). Raised intracranial pressure and seizures were the most frequent signs at presentation. Thirteen (18 %) patients had neurofibromatosis type 2 (NF2). Fifty-three (74 %) patients had a meningioma World Health Organization grade I. Total resection was achieved in 35 of 64 patients. Fifteen patients received radiotherapy postoperatively. Mean follow-up was 4.8 years (range 0-27.8 years). Three patients died as a direct result of their meningioma within 3 years. Four patients with NF2 died as a result of multiple tumors. Nineteen patients had disease progression, requiring additional treatment.
  
  
  CONCLUSIONS
  Meningiomas are extremely rare in the pediatric population; 25 % of all described meningiomas show biological aggressive behavior in terms of disease progression, requiring additional treatment. The 5-year survival is 83.9 %, suggesting that the biological behavior of pediatric menigiomas is more aggressive than that of its adult counterparts.
authors.affiliation: Neurosurgical Center Amsterdam, VU University Medical Center, PO Box 7057, 1007 MB, Amsterdam, The Netherlands. nikkithuijs@hotmail.com
authors.forename: Nikki B
authors.initials: NB
authors.lastname: Thuijs
authors.forename: Bernard M J
authors.initials: BM
authors.lastname: Uitdehaag
authors.forename: Willem J R
authors.initials: WJ
authors.lastname: Van Ouwerkerk
authors.forename: Paul
authors.initials: P
authors.lastname: van der Valk
authors.forename: W Peter
authors.initials: WP
authors.lastname: Vandertop
authors.forename: Saskia M
authors.initials: SM
authors.lastname: Peerdeman
mesh_terms: D000293:Adolescent; D000367:Age Factors; D002490:Central Nervous System / Q000473:pathology; D002648:Child; D002675:Child, Preschool; D016206:Databases, Bibliographic / Q000706:statistics & numerical data; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008579:Meningioma / Q000453:epidemiology* / Q000401:mortality / Q000473:pathology / Q000503:physiopathology; D009426:Netherlands / Q000453:epidemiology; D012189:Retrospective Studies; D012737:Sex Factors; D016019:Survival Analysis