Multiple faces of children and juvenile meningiomas: A report of single-center experience and review of literature
Introduction
Although meningiomas are uncommon in children and adolescents they are undoubtedly an important and challenging tumors for pediatric neurosurgeons. Not only because they differ from their adult counterparts, but also because they are prone to accompany several medical conditions: neurofibromatosis type 2 (NF2), Rubenstein–Taybi syndrome and Castleman disease [1]. Meningiomas amount to 0.4–4.6% of all primary central nervous tumors (CSN) in pediatric group [2]. These may explain why their biological behavior and therapeutical guidelines still remain uncertain.
This report is an attempt to analyze the clinical behavior, pathological picture and recommended management of pediatric meningiomas in comparison to their adult counterparts and to elucidate the differences between sporadic and NF2-related meningiomas on the basis of own experience and literature.
Section snippets
Material and methods
Over a 11-year period (2001–2012) nine patients younger than 18 years were hospitalized at the Department of Neurosurgery at University Children's Hospital, Jagiellonian University Medical College. Altogether there were twenty-four meningiomas in the investigated group. All patients were analyzed retrospectively. The data collected from the hospital records included age, sex, clinical presentation, extent of resection, number of recurrences, associated factors (NF2) and histopathology.
Clinical data
Nine children with meningiomas underwent a surgery in our department in years 2001–2012. We noticed a strong female predominance with six girls and three boys in the study group. Mean age at the first admission to the department was 11.3 years. The youngest child was 5 years old. The mean length of symptoms was 9.5 month ranging from 3 weeks to 3 years. Focal neurological deficits were the most common manifestation of a meningioma in our group (47%), followed by the symptoms of raised
Pediatric vs. adult meningiomas
Pediatric meningiomas in comparison to meningiomas in adults show differences both in clinical and biological aspects. These tumors making up 30% of all primary central nervous system neoplasms in adults, account for only 0.4–4.6% of pediatric ones [2]. According to Central Brain Tumor Registry of the United States, the number of meningiomas raises with age [3]. This data is in line with our results revealing one vs. five children with meningioma in age groups 0–6 and 13–18 years old
Conclusion
Meningiomas in children create a heterogenous group and differ meaningfully from their adult counterparts. Because of that, an individual therapeutic approach is necessary. In pediatric group due to strong association of meningiomas and neurofibromatosis type 2, each child should be investigated thoroughly so that not to overlook silently growing vestibular schwannoma. Resection is the procedure of choice in symptomatic pediatric meningiomas and should be attempted both in sporadic and in
Funding
None declared.
Conflicts of interest
None declared.
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