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Liu J, Zhao K, Wang J, Shu K. Clinical features and long-term outcomes of pediatric meningiomas. Childs Nerv Syst 2021; 37:3041-3047. [PMID: 34292388 DOI: 10.1007/s00381-021-05296-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Accepted: 07/14/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVE Pediatric meningiomas are relatively rare and have atypical clinical features compared to adults. The purpose of this work is to report our 15-year experience in the management of pediatric meningiomas and assess their clinical characteristics, pathological features, and prognostic factors. METHODS A total of 40 children (age ≤ 15 years) who were diagnosed as pediatric meningiomas were enrolled in this study. Patient information including clinical presentation, gender, age at time of diagnosis, histopathological features, tumor location, tumor volume, treatment methods, and follow-up data were extracted and analyzed. RESULTS The mean age at diagnosis was 10.78 ± 3.50 years (range 2-15 years) in 40 patients with a male to female ratio of 1:1.11. Headache, epilepsy, visual disturbance, and limb weakness are common clinical manifestations. Two patients had multiple intracranial meningiomas. Fourteen (33.3%) of pediatric meningiomas were high grade meningiomas. Seven patients (17.5%) were treated with STR, while GTR was achieved in 33 patients (82.5%). The mean follow-up period was 82.1 months (range 9-173 months). Recurrence occurred in 9 patients (22.5%), and 5 patients (12.5%) passed away. CONCLUSION The incidence of pediatric meningiomas increases with advancing age. In pediatric patients, the percentage of high-grade tumors is higher than adults. Younger children were more likely to have high-grade meningiomas, while patients with tumors located in skull base or parasagittal/falx tend to have low-grade meningiomas. The WHO grade III meningiomas were significantly correlated with poor prognosis. Adjuvant radiotherapy after surgery can improve prognosis and may be a potential treatment strategy in children with malignant meningiomas.
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Affiliation(s)
- Jingdian Liu
- Department of Neurosurgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Kai Zhao
- Department of Neurosurgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Junwen Wang
- Department of Neurosurgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.
| | - Kai Shu
- Department of Neurosurgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.
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Ramirez-Grueso R, Patino-Ladino SI, Amortegui-Beltran JA, Rios JL, Estrada-Duque L, Arias J. Intraparenchymal Meningioma. J Med Cases 2021; 12:32-36. [PMID: 34434425 PMCID: PMC8383642 DOI: 10.14740/jmc3592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Accepted: 10/09/2020] [Indexed: 11/11/2022] Open
Abstract
Meningiomas have been described as the most frequent extra-axial tumor in the brain. Most are benign and correspond to World Health Organization (WHO) grade I; however, there are some reports of cases that shows atypical locations, like subcortical intra-axial meningiomas. This represents a challenge in radiological diagnosis because it could be taken as a metastasis tumor or vascular malformations. The authors bring a case report of a previously healthy patient who presents a traumatic brain injury with no traumatic lesions. A computed tomography (CT) evidenced a left frontal rounded subcortical lesion surrounded by large vasogenic edema. The first diagnostic impression was a metastasis tumor. During surgery, a total resection was completed, and the appearance of the tumor was meningioma. This was later confirmed by histological analysis. The literature was reviewed in order to determine the importance of including intraparenchymal meningiomas in the differential diagnosis of intracranial lesions.
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Affiliation(s)
- Raul Ramirez-Grueso
- Department of Neurosurgery, Universidad Nacional de Colombia, USS Tunal, Bogota, Colombia
| | - Sergio I Patino-Ladino
- Department of Neurosurgery, Universidad Nacional de Colombia, USS Tunal, Bogota, Colombia
| | | | - Jose Luis Rios
- Department of Neurosurgery, Universidad Nacional de Colombia, USS Tunal, Bogota, Colombia
| | - Lina Estrada-Duque
- Department of Neurosurgery, Universidad Militar Nueva Granada, USS Tunal, Bogota, Colombia
| | - Jaime Arias
- Department of Neurosurgery, Universidad Nacional de Colombia, USS Tunal, Bogota, Colombia
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Papic V, Lasica N, Jelaca B, Vuckovic N, Kozic D, Djilvesi D, Fimic M, Golubovic J, Pajicic F, Vulekovic P. Primary Intraparenchymal Meningiomas: A Case Report and a Systematic Review. World Neurosurg 2021; 153:52-62. [PMID: 34242832 DOI: 10.1016/j.wneu.2021.06.139] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2021] [Revised: 06/27/2021] [Accepted: 06/28/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND Primary intraparenchymal meningiomas are exceedingly rare and often challenging to diagnose, given their misleading radiologic features. It is hypothesized that they arise from the cap cells of the pia mater that enter the brain via penetrating blood vessels during brain development. We systematically reviewed and analyzed previously reported features of primary intraparenchymal meningiomas in terms of radiography, presenting symptoms, and histopathology. METHODS A literature search of the Web of Science and PubMed databases and crossed references was performed in March 2021, per PRISMA guidelines, with no restrictions regarding publication date. Data regarding demographic features, clinical, radiographic, and histopathologic characteristics were extracted. RESULTS A total of 52 patients (including the reported case) were included in this review. The mean age was 21.1 years (range, 0.3-66 years) with a male/female ratio of 1.9:1. The most common localizations of intraparenchymal meningiomas were in the frontal (30.8%) and temporal (21.2%) lobes. Cyst formation was more readily observed and was noted in 51.4% of patients. Histopathology showed a higher incidence of World Health Organization grade II (14/52, 26.9%) and World Health Organization grade III (7/52, 13.5%) of primary intraparenchymal meningiomas. CONCLUSIONS We present a comprehensive analysis of every reported primary intraparenchymal meningioma. Because of their rarity and capacity to mimic other more common intra-axial tumors, they represent a diagnostic challenge. This systematic review highlights the importance of paying attention to atypical intra-axial lesions, with a particular reflection on the discrepancy between clinical characteristics and imaging features.
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Affiliation(s)
- Vladimir Papic
- Clinic of Neurosurgery, Clinical Center of Vojvodina, Novi Sad, Serbia; Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia
| | - Nebojsa Lasica
- Clinic of Neurosurgery, Clinical Center of Vojvodina, Novi Sad, Serbia; Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia
| | - Bojan Jelaca
- Clinic of Neurosurgery, Clinical Center of Vojvodina, Novi Sad, Serbia; Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia.
| | - Nada Vuckovic
- Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia; Pathology and Histology Center, Clinical Center of Vojvodina, Novi Sad, Serbia
| | - Dusko Kozic
- Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia; Center for Diagnostic Imaging, Oncology Institute of Vojvodina, Sremska Kamenica, Serbia
| | - Djula Djilvesi
- Clinic of Neurosurgery, Clinical Center of Vojvodina, Novi Sad, Serbia; Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia
| | - Miroslav Fimic
- Department of Neurosurgery, Institute for Child and Youth Health Care of Vojvodina, Novi Sad, Serbia
| | - Jagos Golubovic
- Clinic of Neurosurgery, Clinical Center of Vojvodina, Novi Sad, Serbia; Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia
| | - Filip Pajicic
- Clinic of Neurosurgery, Clinical Center of Vojvodina, Novi Sad, Serbia; Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia
| | - Petar Vulekovic
- Clinic of Neurosurgery, Clinical Center of Vojvodina, Novi Sad, Serbia; Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia
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Munjal S, Vats A, Kumar J, Srivastava A, Mehta VS. Giant pediatric intraventricular meningioma: Case report and review of literature. J Pediatr Neurosci 2016; 11:219-222. [PMID: 27857790 PMCID: PMC5108124 DOI: 10.4103/1817-1745.193353] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Intraventricular meningiomas are rare in the pediatric population. These tumors are often large in size and aggressive in behavior when they occur in children. The management of these tumors is a surgical challenge.
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Affiliation(s)
| | - Atul Vats
- Department of Neurosurgery, Paras Hospital, Gurgaon, Haryana, India
| | - Jitendra Kumar
- Department of Neurosurgery, Paras Hospital, Gurgaon, Haryana, India
| | - Amit Srivastava
- Department of Neurosurgery, Paras Hospital, Gurgaon, Haryana, India
| | - Veer Singh Mehta
- Department of Neurosurgery, Paras Hospital, Gurgaon, Haryana, India
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