Surgical experience with meningiomas in the pediatric age

S. Gombini, M. Fornari, G. Cella, C. L. Solero, E. Ciceri, O. Bugiani

Research output: Contribution to journalArticle

Abstract

Intracranial meningiomas are rare tumors in childhood with an incidence of 0.8 to 4.7% of all primary intracranial tumors (1-3). In our department 659 pédiatrie brain tumors have been operated on between 1970 and 1991. Nineteen cases (2.8%) of meningiomas were found in this series. The mean age of children was 9 years (range 1-16 years) and the male/female ratio was 1.22. The meningioma was located in the supratentorial compartment in 14 patients, in the infratentorial region in 4 and within the third ventricle in 1. The average duration of the clinical history was about 7 months (range 1-24 mos). The clinical onset was characterized by increased intracranial pressure (36%), seizures (32%), diplopia (32%), gait disturbance (21%), behavioural change (11%), paresthesia (11%), hemiparesis (11%), impaired vision (11%), headache, (11%). At neurological examination 36% of the patients showed irritability or somnolence, 36% deficit of the oculomotor nerves, 26% cranial asymmetry, 26% hemiparesis, 16% ataxia; 4 children (21%) showed no abnormalities. The radiological study included angiography, CT scan and in the most recent case MRI. The surgical treatment resulted in total excision of the tumor in 90% of the cases with no mortality and 21 % of morbidity which was permanent only in 1 patient (5%) (hemianopsia). The pathological study showed benign lesions in 12 cases (grade I), atypical tumors in 2 cases (grade II) and malignant-sarcomatous features in 5 cases (grade III-IV)(4). At follow up study (mean duration 11 ys) 2 patients with grade I lesion had recurrence of the tumor and underwent a new surgical procedure; 1 died from other causes. One of the 2 patients in grade II had two recurrences with sarcomatous changes. Two of the patients in grade III-IV died after chemoand radio-therapy, 1 and 6 yrs post-op; 3 patients are alive 9, 11 (radio- and chemo-therapy), and 16 ys after surgery. We will discuss the clinical, radiological, pathological and surgical peculiarities of these tumors and the role of chemo- and radio-therapy.

Original languageEnglish
Pages (from-to)20
Number of pages1
JournalSkull Base Surgery
Volume7
Issue numberSUPPL. 1
Publication statusPublished - 1997

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Meningioma
Pediatrics
Radio
Neoplasms
Paresis
Therapeutics
Oculomotor Nerve
Hemianopsia
Recurrence
Third Ventricle
Diplopia
Paresthesia
Neurologic Examination
Intracranial Pressure
Ataxia
Gait
Brain Neoplasms
Headache
Seizures
Morbidity

ASJC Scopus subject areas

  • Clinical Neurology

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Gombini, S., Fornari, M., Cella, G., Solero, C. L., Ciceri, E., & Bugiani, O. (1997). Surgical experience with meningiomas in the pediatric age. Skull Base Surgery, 7(SUPPL. 1), 20.

Surgical experience with meningiomas in the pediatric age. / Gombini, S.; Fornari, M.; Cella, G.; Solero, C. L.; Ciceri, E.; Bugiani, O.

In: Skull Base Surgery, Vol. 7, No. SUPPL. 1, 1997, p. 20.

Research output: Contribution to journalArticle

Gombini, S, Fornari, M, Cella, G, Solero, CL, Ciceri, E & Bugiani, O 1997, 'Surgical experience with meningiomas in the pediatric age', Skull Base Surgery, vol. 7, no. SUPPL. 1, pp. 20.
Gombini S, Fornari M, Cella G, Solero CL, Ciceri E, Bugiani O. Surgical experience with meningiomas in the pediatric age. Skull Base Surgery. 1997;7(SUPPL. 1):20.
Gombini, S. ; Fornari, M. ; Cella, G. ; Solero, C. L. ; Ciceri, E. ; Bugiani, O. / Surgical experience with meningiomas in the pediatric age. In: Skull Base Surgery. 1997 ; Vol. 7, No. SUPPL. 1. pp. 20.
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abstract = "Intracranial meningiomas are rare tumors in childhood with an incidence of 0.8 to 4.7{\%} of all primary intracranial tumors (1-3). In our department 659 p{\'e}diatrie brain tumors have been operated on between 1970 and 1991. Nineteen cases (2.8{\%}) of meningiomas were found in this series. The mean age of children was 9 years (range 1-16 years) and the male/female ratio was 1.22. The meningioma was located in the supratentorial compartment in 14 patients, in the infratentorial region in 4 and within the third ventricle in 1. The average duration of the clinical history was about 7 months (range 1-24 mos). The clinical onset was characterized by increased intracranial pressure (36{\%}), seizures (32{\%}), diplopia (32{\%}), gait disturbance (21{\%}), behavioural change (11{\%}), paresthesia (11{\%}), hemiparesis (11{\%}), impaired vision (11{\%}), headache, (11{\%}). At neurological examination 36{\%} of the patients showed irritability or somnolence, 36{\%} deficit of the oculomotor nerves, 26{\%} cranial asymmetry, 26{\%} hemiparesis, 16{\%} ataxia; 4 children (21{\%}) showed no abnormalities. The radiological study included angiography, CT scan and in the most recent case MRI. The surgical treatment resulted in total excision of the tumor in 90{\%} of the cases with no mortality and 21 {\%} of morbidity which was permanent only in 1 patient (5{\%}) (hemianopsia). The pathological study showed benign lesions in 12 cases (grade I), atypical tumors in 2 cases (grade II) and malignant-sarcomatous features in 5 cases (grade III-IV)(4). At follow up study (mean duration 11 ys) 2 patients with grade I lesion had recurrence of the tumor and underwent a new surgical procedure; 1 died from other causes. One of the 2 patients in grade II had two recurrences with sarcomatous changes. Two of the patients in grade III-IV died after chemoand radio-therapy, 1 and 6 yrs post-op; 3 patients are alive 9, 11 (radio- and chemo-therapy), and 16 ys after surgery. We will discuss the clinical, radiological, pathological and surgical peculiarities of these tumors and the role of chemo- and radio-therapy.",
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