Multiple meningiomas in a child

Intracranial meningiomas in children: report of 27 new cases and critical analysis of 440 cases reported in the literature

We accumulated 440 cases of intracranial meningiomas in patients under 16 years of age, and another 27 personal. This review confirms the existence of specific clinical features of spontaneous and radiation-induced meningioma in children. In addition, we discuss various points that suggest a more aggressive behavior of meningiomas in children than in adults. (J Child Neurol 2006;21:31-36).

Multiple skull base meningioma: case report

BACKGROUND

The incidence of multiple skull base meningiomas varies from 1 to 3% in different series. Skull base meningiomas are rare. The pathogenetic role of low-dose radiation seems to be fairly well established in the oncogenesis of meningiomas. Calvarial location and multiplicity seem to be among the distinctive features of radiation-induced meningiomas. Skull base location is a very rare occurrence, mainly because the path of irradiation does not significantly involve this region.

CASE REPORT

We describe a rare case of simultaneous occurrence of two skull base meningiomas in a 66-year-old female. This patient underwent low-dose irradiation for tinea capitis when she was 8 years old. The patient complained of nuchal pain, paresthesias in both hands, and progressive weakness on her right side. She was admitted to the hospital in September 1994. An MRI showed two masses, one located at the level of the tuberculum sellae and the other at the foramen magnum. These seemed very likely to be multiple meningiomas. The latter lesion, which was more symptomatic and dangerous, was operated on first. Six months later, elective treatment of the suprasellar meningioma was performed with success.

CONCLUSION

The actual role of previous head irradiation in the oncogenesis of the present meningiomas remains somewhat unclear. Proper management and judicious use of skull base surgery techniques were key factors in the successful treatment of the patient.

The deletion of 22q13 region in both intracranial and spinal meningiomas in a patient (case report)

We present a 69 year old man with two simultaneous meningiomas in different compartment of neural axis, in both of which 22q13 locus is lost. Histologically the two tumours appeared to be different; meningotheliomatous and transitional with psammoma bodies, respectively. No numerical or structural chromosome abnormalities were seen in karyotype analysis of the cultured spinal and cranial meningioma samples. Since long arm structural aberrations and/or whole loss of chromosome 22 are frequently reported abnormalities of meningiomas, the tumours were also analysed by fluorescence in situ hybridisation (FISH) with different colour-labelled probes in respect to relevant chromosome. The metaphases and interphase nuclei of the samples were evaluated by the combined biotinylated 22q11 and digoxigenin-labelled 22q13 locus specific FISH probes, and 22q13 deletion was revealed in both of spinal and cranial tumour cells. In conclusion, since both tumours from the presented case show the same genetic alterations, multiplicity may be derived from the same clone of cells, and support the theory of development of multiple meningiomas from the spreading of tumour cells via cerebrospinal fluid as a possible mechanism.

Multiple extracranial meningiomas in a child

Meningioma is an uncommon tumour in childhood. We report the case of a child presenting with proptosis, which proved to be due to an optic nerve sheath meningioma. Subsequently, he complained of back pain and stiffness, and upon investigation this was also revealed to be due to a meningioma.

Epidural spinal meningioma. Role of magnetic resonance in differential diagnosis

A rare case of an extradurally growing spinal meningioma in an elderly woman is reported. Neuro-imaging, particularly magnetic resonance (MR), allowed to recognize the lesion, which, otherwise, could raise problems of differential diagnosis with a spinal metastasis. An emergency operation, required by a sudden neurological deterioration, was decisive in recovery of neurological deficits. In a review of the literature, extradurally growing spinal meningiomas appear to occur with a higher frequency than it is thought. Therefore, they are to be suspected when dealing with extradural spinal lesions.

Multiple meningiomas and their relation to neurofibromatosis. Review of the literature and report of seven cases

A review of 158 cases of multiple meningiomas reported in the literature and 7 additional cases are presented. The average incidence of multiple meningiomas is 2.5% of all meningiomas. In the absence of cutaneous manifestations of von Recklinghausen's disease, it is extremely difficult to distinguish between cases associated with central neurofibromatosis and those representing true multiple meningiomas. There are no specific pathognomonic features that distinguish true multiple meningiomas as a separate disease entity.

Paediatric intracranial meningiomas

Intracranial meningiomas are rare before the age of 16 years. Of 1397 intracranial meningiomas operated on by our service up to 1987, 19 (1.3%) were diagnosed before this age. In the literature accessible to us we have found another 274 cases. An analysis of the literature shows that intracranial meningiomas in paediatric patients differ from those in adults in the following respects: a slight predilection for males, a high frequency within the ventricular system, more frequent presence of intra- and peri-lesional cysts and more frequent absence of dural attachment. In addition, the neuroradiologic diagnosis of nature is more difficult in paediatric patients.