Pediatric meningiomas: a single-center experience with 15 consecutive cases and review of the literature.
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.
Division of Pediatric Neurosurgery of the Department of Surgery and Anatomy, University Hospital of Ribeirão Preto Medical School, University of São Paulo, 14049-900, Ribeirão Preto, Brazil.
Marcelo Volpon
MV
Santos
Luciano
L
Furlanetti
Elvis Terci
ET
Valera
Maria Sol
MS
Brassesco
Luiz Gonzaga
LG
Tone
Ricardo Santos
RS
de Oliveira
D000293:Adolescent; D001921:Brain / Q000473:pathology; D002648:Child; D020732:Cytogenetic Analysis; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008577:Meningeal Neoplasms / Q000175:diagnosis* / Q000235:genetics / Q000628:therapy*; D008579:Meningioma / Q000175:diagnosis / Q000235:genetics / Q000628:therapy*; D010372:Pediatrics; D012189:Retrospective Studies; D013116:Spinal Cord / Q000473:pathology