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 journalArticlepeer-review

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

ASJC Scopus subject areas

  • Clinical Neurology

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