Revista argentina de neurocirugía
version ISSN 1850-1532
CONTRERAS, Fernando and AUAD, Federico. Meningiomas en pediatría: Premio Junior 42º Congreso Argentino de Neurocirugía. Rev. argent. neurocir. [online]. 2010, vol.24, n.4, pp. 181-189. ISSN 1850-1532.
Objective. To study clinical signs, epidemiology, follow up, treatment and prognosis of intracranial meningiomas in child-hood and correlates them with the same pathology in the adult population. Material and method. 25 patients under 16 years with meningiomas were treated in our Hospital in the last 20 years (1989-2009). The study included their age and sex distribution, clinical signs, neuroimages, localization of the lesion, NF association, follow up, surgical removal, pathological subtypes of meningiomas, morbimortality and recurrence. Results. The male-to-female ratio was 1,1:1 (13:12) and the mean age was 10 years ranging from 11 months to 15.6 years. Seizure was the most common symptom (36%) followed by intracranial hypertension (28%). Lesion localization: 15 supra-tentorial, 6 in the posterior fossa, 2 extracraneal and 2 spinal. Seven patient had NF 1/2 association. All patients were treated with surgery. Perioperative mortality was of 1 patient and the global mortality was of 3 patients, two caused by non-tumor-related events (gastrointestinal hemorrhage - Steven Johnson syndrome) and in the other case by tumor progression. Total removal (100%) was achieved in 16 patients, subtotal removal (60 to 99%) in 7 and partial in 2 patients. Preoperative symptoms improved in 14 patients, 6 remained unchanged, 4 had further deficit, and 1 died. The recurrence was 1/16 in total removal, 6/ 7 in subtotal removal and 2/2 in partial removal. Eleven patients required more than one surgery. Meningotheliomatous meningioma was the most frequent subtype. Conclusion. Meningiomas in childhood are infrequent. There is no gender predominance as in adults. The Neurofibromatosis and previous radiation treatment are the most important risk factors. Total removal is the most important prognostic factor.
Keywords : Meningioma; Central Nervous Sistem Tumor; Neurofibromatosis; Radiation-therapy; Pediatrics.