Intracranial meningiomas in children: Review of 29 cases

BACKGROUND Meningiomas are predominantly tumors of the fifth and sixth decades of life. Although rare in infancy and childhood, they represent an important field in pediatric neurosurgery. METHODS Twenty-nine children under 15 years of age with intracranial meningiomas were treated during the period 1968-1994 in the Department of Pediatric Neurosurgery in Marseille (23 cases) and in the Department of Neurosurgery of Cerrahpasa Medical School in Istanbul (6 cases). These tumors represented 2.4% of all central nervous system (CNS) tumors in this age group. RESULTS There were 18 boys and 11 girls. Eighteen cases (62%) occured between 10 and 15 years of age and two cases were infants. Twelve children (41%) had associated neurofibromatosis. Presenting symptoms were related to the tumor location. Thirty-one intracranial meningiomas were observed in these 29 children. Cerebral convexity was the most common location and 13% of the tumors had no dural attachment. Thirty-one tumors were operated on and total removal was achieved in 25 patients (86.2%). Five patients died, one during surgery. There was no mortality among the 17 children without neurofibromatosis. After a mean 6.5 year follow-up period, 13 patients (45%) are neurologically intact, 8 patients (27.5%) have a moderate disability, without evidence of tumor recurrence. CONCLUSION Childhood meningiomas occur predominantly in males. Absence of dural attachment is more common in children than in adults. Childhood meningiomas have a low recurrence rate. They are frequently associated with neurofibromatosis; this is the most important factor influencing outcome. (C) 1998 by Elsevier Science Inc.