MENINGIOMA IN CHILDREN - A REPORT OF 9 CASES AND REVIEW OF THE LITERATURE

BACKGROUND Meningioma is a common tumor of the central nervous system in adults, accounting for 10%-20% of all primary intracranial tumors. It is rare in children, with an incidence of 2.19% (0.85%-2.3%). Altho ugh there are numerous case reports in the literature, no firm conclus ions can be drawn. For this report we accumulated, reviewed, and analy zed reports in the literature from 1960-93. METHODS A total of 318 pat ients with meningioma were managed in King Faisal Specialist Hospital and Research Centre from 1981-93. Nine of these patients (2.8%) were c hildren aged 16 years or less. These cases were analyzed retrospective ly with regard to age, sex, clinical presentation, radiologic findings , pathologic findings, management, and outcome. RESULTS Childhood meni ngioma represented 2.8% of all meningioma cases and 2.2% of all centra l nervous system tumors seen in children. There were six males and thr ee females. The average age at presentation was 10.1 years (range 1-16 years). There were four cases of meningioma in the orbit and one each in the temporal region, foramen magnum, tentorial region, subfrontal base, sellar region, and ethmoidal air sinus, There were two cases of multiple meningioma. Meningothelial meningioma was the type most frequ ently seen. CONCLUSION Meningioma is rare in children and males are af fected more than females. Tumor locations that are rare in adults are more common in children. The meningothelial type is most frequently se en. Prognosis is poor compared with that in adults, as the tumors tend to grow more rapidly and to a larger size, undergo malignant changes, and have a greater rate of recurrence. Whenever feasible, every effor t should be made to achieve total resection of the tumor at the first attempt. If radiation therapy is used in children it should be limited to those who have recurrent tumors so as to minimize organic and psyc hologic complications.