Pediatric intraventricular meningioma

Li et al. analyzed a total of 30 pediatric patients with intraventricular meningiomas who were surgically treated at our department between January 2005 and June 2016 and analyzed their clinical characteristics and surgical outcomes. Among the 160 pediatric patients with intracranial meningioma, 33 (20.6%) had intraventricular lesions. However, only 30 patients had complete demographic and clinical data. A male predilection (male/female = 1.5:1) was observed, and the mean age of our patient cohort was 12.6 years. The lateral ventricle was the most common lesion site (88.6%). In addition, the most common initial symptom was headache or dizziness, and the average interval from symptom onset to admission was 19.17 months (0.25-72 months). Twenty-six patients (86.7%) achieved a Simpson grade of I. Based on the WHO classification, 28 (93.3%) meningiomas were classified as grade I, and the remaining two cases were grades II and III. During the follow-up period (0.67-10.08 years), 3 patients experienced tumor recurrence (15, 18, and 83 months, respectively), and 1 patient died of recurrence. Pediatric and adult intraventricular meningiomas present similar clinical characteristics and surgical outcomes; however, intraventricular meningiomas compose a higher percentage of pediatric meningiomas and have a male predilection. Compared with general pediatric meningiomas, pediatric intraventricular meningiomas tend to have a higher incidence of benign subtypes. They are also more likely to be completely resected and have lower recurrence and mortality rates ¹⁾.

6 pediatric patients (age ≤18 years) with histopathologically proven IVM. The mean age in this series was 14.6 years. Tumor was most commonly approached through the superior parietal lobule in this series. Gross total excision was achieved in all patients. The blood loss in the series was in the range of 600-2000 ml with a mean of 1100 ml. All were grade 1 meningioma on histopathological examination. Transitional meningioma was the most common histological subtype. None of the patients had a recurrence at the last follow-up.

Pediatric IVMs are rare tumors. They tend to have a male preponderance in contrast to adults who have a preference for females. Parietooccipital transcortical, transcallosal approach and middle/inferior temporal gyrus approach are the described techniques to tackle such tumors depending on the location of such tumors. Surgeons should watch out for massive blood loss during surgery, especially via the parietooccipital transcortical approach ²⁾.