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Clinical features and long-term outcomes of pediatric meningiomas

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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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References

  1. Ostrom QT, Gittleman H, Truitt G, Boscia A, Kruchko C, Barnholtz-Sloan JS (2018) CBTRUS Statistical report: primary brain and other central nervous system tumors diagnosed in the United States in 2011–2015. Neuro Oncol 20: iv1-iv86. https://doi.org/10.1093/neuonc/noy131

  2. Louis DN, Perry A, Reifenberger G, von Deimling A, Figarella-Branger D, Cavenee WK, Ohgaki H, Wiestler OD, Kleihues P, Ellison DW (2016) The 2016 World Health Organization Classification of Tumors of the Central Nervous System: a summary. Acta Neuropathol 131:803–820. https://doi.org/10.1007/s00401-016-1545-1

    Article  PubMed  Google Scholar 

  3. Gao X, Zhang R, Mao Y, Wang Y (2009) Childhood and juvenile meningiomas. Childs Nerv Syst 25:1571–1580. https://doi.org/10.1007/s00381-009-0964-x

    Article  PubMed  Google Scholar 

  4. Greene S, Nair N, Ojemann JG, Ellenbogen RG, Avellino AM (2008) Meningiomas in children. Pediatr Neurosurg 44:9–13. https://doi.org/10.1159/000110656

    Article  PubMed  Google Scholar 

  5. Tufan K, Dogulu F, Kurt G, Emmez H, Ceviker N, Baykaner MK (2005) Intracranial meningiomas of childhood and adolescence. Pediatr Neurosurg 41:1–7. https://doi.org/10.1159/000084858

    Article  PubMed  Google Scholar 

  6. Perry A, Dehner LP (2003) Meningeal tumors of childhood and infancy. An update and literature review. Brain Pathol 13:386–408. https://doi.org/10.1111/j.1750-3639.2003.tb00038.x

    Article  PubMed  Google Scholar 

  7. Miranda P, Simal JA, Vila M, Hernandez M, Menor F, Alvarez-Garijo JA (2009) Posterior fossa clear cell meningioma without dural attachment in a child. Childs Nerv Syst 25:389–392. https://doi.org/10.1007/s00381-008-0757-7

    Article  PubMed  Google Scholar 

  8. Gump WC (2015) Meningiomas of the pediatric skull base: a review. J Neurol Surg B Skull Base 76:66–73. https://doi.org/10.1055/s-0034-1390012

    Article  PubMed  Google Scholar 

  9. Stanuszek A, Piatek P, Kwiatkowski S, Adamek D (2014) Multiple faces of children and juvenile meningiomas: a report of single-center experience and review of literature. Clin Neurol Neurosurg 118:69–75. https://doi.org/10.1016/j.clineuro.2013.12.019

    Article  PubMed  Google Scholar 

  10. Teixidor P, Guillen A, Cruz O, Costa JM (2008) Intracranial meningiomas in children: report of 10 cases. Neurocirugia (Astur) 19:434–439

    Article  CAS  Google Scholar 

  11. Li Z, Li H, Jiao Y, Ma J, Wang S, Zhao J, Cao Y (2017) A comparison of clinicopathological features and surgical outcomes between pediatric skull base and non-skull base meningiomas. Childs Nerv Syst 33:595–600. https://doi.org/10.1007/s00381-016-3278-9

    Article  PubMed  Google Scholar 

  12. Kotecha RS, Junckerstorff RC, Lee S, Cole CH, Gottardo NG (2011) Pediatric meningioma: current approaches and future direction. J Neurooncol 104:1–10. https://doi.org/10.1007/s11060-010-0503-3

    Article  PubMed  Google Scholar 

  13. Hatef J, Adamson C, Obiga O, Taremwa B, Ssenyojo H, Muhumuza M, Haglund M, Schroeder K (2014) Central nervous system tumor distribution at a tertiary referral center in Uganda. World Neurosurg 82:258–265. https://doi.org/10.1016/j.wneu.2014.06.040

    Article  PubMed  Google Scholar 

  14. Kotecha RS, Pascoe EM, Rushing EJ, Rorke-Adams LB, Zwerdling T, Gao X, Li X, Greene S, Amirjamshidi A, Kim SK, Lima MA, Hung PC, Lakhdar F, Mehta N, Liu Y, Devi BI, Sudhir BJ, Lund-Johansen M, Gjerris F, Cole CH, Gottardo NG (2011) Meningiomas in children and adolescents: a meta-analysis of individual patient data. Lancet Oncol 12:1229–1239. https://doi.org/10.1016/S1470-2045(11)70275-3

    Article  PubMed  Google Scholar 

  15. Dudley RWR, Torok MR, Randall S, Beland B, Handler MH, Mulcahy-Levy JM, Liu AK, Hankinson TC (2018) Pediatric versus adult meningioma: comparison of epidemiology, treatments, and outcomes using the Surveillance, Epidemiology, and End Results database. J Neurooncol 137:621–629. https://doi.org/10.1007/s11060-018-2756-1

    Article  PubMed  Google Scholar 

  16. Ravindranath K, Vasudevan MC, Pande A, Symss N (2013) Management of pediatric intracranial meningiomas: an analysis of 31 cases and review of literature. Childs Nerv Syst 29:573–582. https://doi.org/10.1007/s00381-012-2010-7

    Article  PubMed  Google Scholar 

  17. Thuijs NB, Uitdehaag BM, Van Ouwerkerk WJ, van der Valk P, Vandertop WP, Peerdeman SM (2012) Pediatric meningiomas in The Netherlands 1974–2010: a descriptive epidemiological case study. Childs Nerv Syst 28:1009–1015. https://doi.org/10.1007/s00381-012-1759-z

    Article  PubMed  PubMed Central  Google Scholar 

  18. Grossbach AJ, Mahaney KB, Menezes AH (2017) Pediatric meningiomas: 65-year experience at a single institution. J Neurosurg Pediatr 20:42–50. https://doi.org/10.3171/2017.2.PEDS16497

    Article  PubMed  Google Scholar 

  19. Liu Y, Li F, Zhu S, Liu M, Wu C (2008) Clinical features and treatment of meningiomas in children: report of 12 cases and literature review. Pediatr Neurosurg 44:112–117. https://doi.org/10.1159/000113112

    Article  PubMed  Google Scholar 

  20. Molleston MC, Moran CJ, Roth KA, Rich KM (1994) Infantile meningioma. Pediatr Neurosurg 21:195–200. https://doi.org/10.1159/000120835

    Article  CAS  PubMed  Google Scholar 

  21. El Beltagy MA, Enayet AE, Atteya MME, Reda M, Refaat A, Taha H, Ahmed S, Abdelaziz A (2019) Management of pediatric CNS meningiomas: CCHE-57357 experience in 39 cases. Childs Nerv Syst 35:1323–1331. https://doi.org/10.1007/s00381-019-04156-6

    Article  PubMed  Google Scholar 

  22. Santos MV, Furlanetti L, Valera ET, Brassesco MS, Tone LG, de Oliveira RS (2012) Pediatric meningiomas: a single-center experience with 15 consecutive cases and review of the literature. Childs Nerv Syst 28:1887–1896. https://doi.org/10.1007/s00381-012-1823-8

    Article  PubMed  Google Scholar 

  23. Lakhdar F, Arkha Y, El Ouahabi A, Melhaoui A, Rifi L, Derraz S, El Khamlichi A (2010) Intracranial meningioma in children: different from adult forms? A series of 21 cases. Neurochirurgie 56:309–314. https://doi.org/10.1016/j.neuchi.2010.05.008

    Article  CAS  PubMed  Google Scholar 

  24. Mehta N, Bhagwati S, Parulekar G (2009) Meningiomas in children: A study of 18 cases. J Pediatr Neurosci 4:61–65. https://doi.org/10.4103/1817-1745.57322

    Article  PubMed  PubMed Central  Google Scholar 

  25. Caroli E, Russillo M, Ferrante L (2006) Intracranial meningiomas in children: report of 27 new cases and critical analysis of 440 cases reported in the literature. J Child Neurol 21:31–36. https://doi.org/10.1177/08830738060210010801

    Article  PubMed  Google Scholar 

  26. Dash C, Pasricha R, Gurjar H, Singh PK, Sharma BS (2016) Pediatric intraventricular meningioma: a series of six cases. J Pediatr Neurosci 11:193–196. https://doi.org/10.4103/1817-1745.193356

    Article  PubMed  PubMed Central  Google Scholar 

  27. Deen HG Jr, Scheithauer BW, Ebersold MJ (1982) Clinical and pathological study of meningiomas of the first two decades of life. J Neurosurg 56:317–322. https://doi.org/10.3171/jns.1982.56.3.0317

    Article  PubMed  Google Scholar 

  28. Menon G, Nair S, Sudhir J, Rao BR, Mathew A, Bahuleyan B (2009) Childhood and adolescent meningiomas: a report of 38 cases and review of literature. Acta Neurochir (Wien) 151: 239–244; discussion 244. https://doi.org/10.1007/s00701-009-0206-8

  29. Odebode TO, Akang EE, Shokunbi MT, Malamo AO, Ogunseyinde AO (2006) Factors influencing visual and clinical outcome in Nigerian patients with cranial meningioma. J Clin Neurosci 13:649–654. https://doi.org/10.1016/j.jocn.2005.07.023

    Article  CAS  PubMed  Google Scholar 

  30. Merten DF, Gooding CA, Newton TH, Malamud N (1974) Meningiomas of childhood and adolescence. J Pediatr 84:696–700. https://doi.org/10.1016/s0022-3476(74)80011-9

    Article  CAS  PubMed  Google Scholar 

  31. Modha A, Gutin PH (2005) Diagnosis and treatment of atypical and anaplastic meningiomas: a review. Neurosurgery 57: 538–550; discussion 538–550. https://doi.org/10.1227/01.neu.0000170980.47582.a5

  32. Zhou P, Ma W, Yin S, Li Y, Jiang S (2013) Three risk factors for WHO grade II and III meningiomas: a study of 1737 cases from a single center. Neurol India 61:40–44. https://doi.org/10.4103/0028-3886.107928

    Article  PubMed  Google Scholar 

  33. He W, Liu Z, Teng H, Tang L, Jie D, Duan Z, Yu H, Xu J (2020) Pediatric meningiomas: 10-year experience with 39 patients. J Neurooncol 149:543–553. https://doi.org/10.1007/s11060-020-03649-8

    Article  PubMed  Google Scholar 

  34. Hui M, Uppin MS, Saradhi MV, Sahu BP, Purohit AK, Sundaram C (2015) Pediatric meningiomas an aggressive subset: a clinicopathological and immunohistochemical study. J Postgrad Med 61:32–35. https://doi.org/10.4103/0022-3859.147035

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  35. Kane AJ, Sughrue ME, Rutkowski MJ, Shangari G, Fang S, McDermott MW, Berger MS, Parsa AT (2011) Anatomic location is a risk factor for atypical and malignant meningiomas. Cancer 117:1272–1278. https://doi.org/10.1002/cncr.25591

    Article  PubMed  Google Scholar 

  36. Kuster O, Schittenhelm J, Schwartz O, Meyermann R, Schuhmann MU (2012) Paediatric clear cell meningioma with multiple distant recurrences after presumed intra-operative cell spread. Childs Nerv Syst 28:925–931. https://doi.org/10.1007/s00381-011-1669-5

    Article  PubMed  Google Scholar 

  37. Larrew T, Eskandari R (2016) Pediatric Intraparenchymal Meningioma: Case Report and Comparative Review. Pediatr Neurosurg 51:83–86. https://doi.org/10.1159/000441008

    Article  PubMed  Google Scholar 

  38. Sade B, Chahlavi A, Krishnaney A, Nagel S, Choi E, Lee JH (2007) World Health Organization Grades II and III meningiomas are rare in the cranial base and spine. Neurosurgery 61: 1194–1198; discussion 1198. https://doi.org/10.1227/01.neu.0000306097.38141.65

  39. Kepes JJ (1986) Presidential address: the histopathology of meningiomas. A reflection of origins and expected behavior? J Neuropathol Exp Neurol 45:95–107

    Article  CAS  Google Scholar 

  40. Lee JH, Sade B, Choi E, Golubic M, Prayson R (2006) Meningothelioma as the predominant histological subtype of midline skull base and spinal meningioma. J Neurosurg 105:60–64. https://doi.org/10.3171/jns.2006.105.1.60

    Article  PubMed  Google Scholar 

  41. Li Z, Li H, Jiao Y, Ma J, Wang S, Cao Y, Zhao J (2018) Clinical features and long-term outcomes of pediatric intraventricular meningiomas: data from a single neurosurgical center. Neurosurg Rev 41:525–530. https://doi.org/10.1007/s10143-017-0884-2

    Article  PubMed  Google Scholar 

  42. Dziuk TW, Woo S, Butler EB, Thornby J, Grossman R, Dennis WS, Lu H, Carpenter LS, Chiu JK (1998) Malignant meningioma: an indication for initial aggressive surgery and adjuvant radiotherapy. J Neurooncol 37:177–188. https://doi.org/10.1023/a:1005853720926

    Article  CAS  PubMed  Google Scholar 

  43. Toland A, McNulty SN, Pekmezci M, Evenson M, Huntoon K, Pierson CR, Boue DR, Perry A, Dahiya S (2020) Pediatric meningioma: a clinicopathologic and molecular study with potential grading implications. Brain Pathol 30:1134–1143. https://doi.org/10.1111/bpa.12884

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  44. McNulty SN, Schwetye K, Goldstein M, Carter J, Schmidt RE, Ansstas G, Tsien CI, Kim AH, Dahiya S (2018) Analysis of point mutations and copy number variation in Grade II and III meningioma. Exp Mol Pathol 105:328–333. https://doi.org/10.1016/j.yexmp.2018.10.007

    Article  CAS  PubMed  Google Scholar 

  45. Katz LM, Hielscher T, Liechty B, Silverman J, Zagzag D, Sen R, Wu P, Golfinos JG, Reuss D, Neidert MC, Wirsching HG, Baumgarten P, Herold-Mende C, Wick W, Harter PN, Weller M, von Deimling A, Snuderl M, Sen C, Sahm F (2018) Loss of histone H3K27me3 identifies a subset of meningiomas with increased risk of recurrence. Acta Neuropathol 135:955–963. https://doi.org/10.1007/s00401-018-1844-9

    Article  CAS  PubMed  Google Scholar 

  46. Clark VE, Erson-Omay EZ, Serin A, Yin J, Cotney J, Ozduman K, Avsar T, Li J, Murray PB, Henegariu O, Yilmaz S, Gunel JM, Carrion-Grant G, Yilmaz B, Grady C, Tanrikulu B, Bakircioglu M, Kaymakcalan H, Caglayan AO, Sencar L, Ceyhun E, Atik AF, Bayri Y, Bai H, Kolb LE, Hebert RM, Omay SB, Mishra-Gorur K, Choi M, Overton JD, Holland EC, Mane S, State MW, Bilguvar K, Baehring JM, Gutin PH, Piepmeier JM, Vortmeyer A, Brennan CW, Pamir MN, Kilic T, Lifton RP, Noonan JP, Yasuno K, Gunel M (2013) Genomic analysis of non-NF2 meningiomas reveals mutations in TRAF7, KLF4, AKT1, and SMO. Science 339:1077–1080. https://doi.org/10.1126/science.1233009

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  47. Battu S, Kumar A, Pathak P, Purkait S, Dhawan L, Sharma MC, Suri A, Singh M, Sarkar C, Suri V (2018) Clinicopathological and molecular characteristics of pediatric meningiomas. Neuropathology 38:22–33. https://doi.org/10.1111/neup.12426

    Article  CAS  PubMed  Google Scholar 

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Funding

This work was supported by National Natural Science Foundation of China (grant no. 81702478 and 81602204).

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Correspondence to Junwen Wang or Kai Shu.

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Jingdian Liu and Kai Zhao contributed equally in this work.

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Liu, J., Zhao, K., Wang, J. et al. Clinical features and long-term outcomes of pediatric meningiomas. Childs Nerv Syst 37, 3041–3047 (2021). https://doi.org/10.1007/s00381-021-05296-4

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