Abstract
Meningiomas in the pediatric population are rare, diverse, and poorly defined. Available evidence on the clinical course, optimal treatment strategy, and outcome of these tumors is based on small, single-institution, retrospective case series or extrapolated from the adult medical literature. The behavior and underlying biology of pediatric tumors differs from their adult counterparts, and their management presents unique challenges. While the majority of meningiomas in children are sporadic, several risk factors for the development of these tumors have been identified. These include exposure to ionizing radiation, association with specific clinical and genetic syndromes (particularly neurofibromatosis type 2), and a family history of meningioma. Pediatric meningiomas can encompass the full range of histopathological variants, and while the majority of tumors are reported as WHO grade I, the higher-grade subtypes occur at a higher incidence in the pediatric population than in adults. The primary treatment of choice for meningioma in childhood is gross total resection, with the extent of surgical resection being the strongest independent prognostic factor. No conclusive data exist regarding indications for radiotherapy as adjuvant treatment for pediatric meningioma. The late toxicities on the developing brain and the risk of repeated recurrences necessitating surgical intervention in children require clinical decision-making that is tailored to each patient. Associated factors such as radiation exposure, presence of neurofibromatosis, location of tumor, and extent of resection may carry more importance than histopathologic grade in determining long-term outcome. The majority of pediatric patients with meningioma have favorable outcomes.
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Baird, L.C., Selden, N.R. (2020). Pediatric Meningioma. In: Di Rocco, C., Pang, D., Rutka, J. (eds) Textbook of Pediatric Neurosurgery. Springer, Cham. https://doi.org/10.1007/978-3-319-72168-2_93
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DOI: https://doi.org/10.1007/978-3-319-72168-2_93
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