Childhood and adolescent meningiomas: a report of 38 cases and review of literature

Acta Neurochir (Wien). 2009 Mar;151(3):239-44; discussion 244. doi: 10.1007/s00701-009-0206-8. Epub 2009 Feb 24.


Background: The aim is to study the clinical, radiological and pathological features of childhood and adolescent meningiomas and analyse outcome prognosticators.

Method: A retrospective analysis of the case records of patients less than 20 years of age operated for a meningioma in our institute since 1982 was performed. The variables analysed included age, sex, presentation, associated neurofibromatosis (NF), imaging characteristics, extent of resection and histopathology.

Results: The study group included 20 males and 18 females with a mean age of 15.53 years. Eleven children (28.9%) had evidence of NF of whom three had NF2 with bilateral vestibular schwannomas. The common presenting symptoms were seizures (76.3%), raised intracranial tension (71%), and focal neurological deficits (39.4%). The location of the operated tumours were as follows: ten skull base (24.4%), ten falx/parasagittal (24.4%), eight spinal (19.5%), five convexity (12.2%), three posterior fossa (7.3%), three intraventricular (7.3%) and two optic nerve sheath (4.9%). Two children (4.9%) had cystic meningiomas. Grade I excision was achieved only in twenty tumours (48.8%). On histopathology, thirty (73.2%) were grade I, nine (21.9%) were grade II and two (4.9%) were grade III meningiomas. Seven tumours recurred of which six were located at the skull base. During the mean follow up period of 4.74 years, the majority, 32 (84.2%) had a good outcome and five (13.2%) had a poor outcome. One child (2.6%) expired due to post-operative sepsis.

Conclusion: Childhood meningiomas are uncommon but not rare lesions with a marginal male predominance. Absence of large series with long follow up precludes any definite conclusions on the clinical course and outcome. Uniform observations made in different series including ours, include a higher incidence of the skull base location and tumours with atypical histopathology. Favourable prognostic factors include younger age (< than 10 years), superficial location, total excision and absence of neurofibromatosis. Location and extent of excision appear to be more important than histopathology grade in predicting outcome.

MeSH terms

  • Adolescent
  • Age Factors
  • Child
  • Comorbidity
  • Dura Mater / pathology
  • Dura Mater / surgery
  • Female
  • Humans
  • Intracranial Hypertension / etiology
  • Male
  • Meningeal Neoplasms / epidemiology*
  • Meningeal Neoplasms / pathology
  • Meningeal Neoplasms / surgery*
  • Meningioma / epidemiology*
  • Meningioma / pathology
  • Meningioma / surgery*
  • Neoplasm Recurrence, Local / epidemiology
  • Neurofibromatoses / epidemiology*
  • Neuroma, Acoustic / epidemiology
  • Neurosurgical Procedures
  • Optic Nerve / pathology
  • Retrospective Studies
  • Seizures / etiology
  • Skull / pathology
  • Skull / surgery*
  • Skull Base Neoplasms / epidemiology
  • Skull Base Neoplasms / pathology
  • Skull Base Neoplasms / surgery
  • Spinal Neoplasms / epidemiology
  • Spinal Neoplasms / pathology
  • Spinal Neoplasms / surgery
  • Treatment Outcome