Childhood Meningiomas

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Abstract
Twenty children with meningiomas (ages 18 months to 17 years) received initial therapy at the Children’s Hospital of Philadelphia between January 1975 and June 1991, accounting for 2 % of children with primary brain tumors seen during that time interval. All were verified histopathologically, and none had had prior irradiation. Fifteen were male and 5 female. Fifteen tumors were intracranial, all located supratentorially. Two of these also had a component within the optic canal. One tumor was entirely within the orbit. Four meningiomas arose within the spinal canal. Associated conditions were neurofibro-matosis (NF) type I (1 patient), NF type II (2 patients), and a facial alveolar rhabdomysarcoma (1 patient). A gross total resection as documented by postoperative scan and operative note was accomplished in 12 patients. Four of these relapsed, at a mean of 3.5 years from initial surgery. In 4 patients a near-total resection (>90%) was performed. Of these, 2 progressed at 9 months and 1.5 years. One of these died of complications associated with reoperation. In 4 patients a partial resection (50–90%) was performed. Two of these progressed at 4 months and 1 year, and the other 2 have been followed for less than 2 years. Five patients received radiation therapy (RT). One patient received RT as adjunctive therapy after primary surgery because of papillary histology. The other 4 had RT following reoperation for recurrence at a mean of 1.5 years from diagnosis (range, 7 months to 2 years). These 4 patients remain alive and with stable disease at a mean of 6 years from diagnosis (range 2–8.8 years). The crude relapse-free and overall survival rates were 60% (12/20) and 95% (19/20), respectively, at a mean of 5.8 years after diagnosis. This single institution series confirms both the relatively favorable outcome of these tumors despite a high recurrence rate, and the value of radiation therapy in delaying progression.

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