Dash Chinmaya, Pasricha Ribhav, Gurjar Hitesh, Singh Pankaj Kumar, Sharma Bhawani Shankar
Department of Neurosurgery, All Institute of Medical Sciences, New Delhi, India.
J Pediatr Neurosci. 2016 Jul-Sep;11(3):193-196. doi: 10.4103/1817-1745.193356.
Meningiomas in children is a rare occurrence. Primary intraventricular meningiomas (IVMs) are even rarer with reported incidence of 0.5%-5% of all meningiomas. The aim of the study was to describe the demographic profile, location, surgical approach, complications, and histopathology of six pediatric patients with IVM.
We retrospectively analyzed all intraventricular tumors operated at our Institute from January 2010 till July 2015. Patients' clinical details and follow-up were obtained from hospital records and scans were obtained from picture archiving and communication system.
We found 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 last follow-up.
Pediatric IVMs are rare tumors. They tend to have a male preponderance in contrast to adults which have a preference for females. Parietooccipital transcortical, transcallosal approach, 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.
儿童脑膜瘤较为罕见。原发性脑室内脑膜瘤(IVM)更为罕见,据报道其发病率占所有脑膜瘤的0.5%-5%。本研究的目的是描述6例儿童IVM患者的人口统计学特征、肿瘤位置、手术方法、并发症及组织病理学情况。
我们回顾性分析了2010年1月至2015年7月在我院接受手术的所有脑室内肿瘤患者。患者的临床详细资料和随访情况从医院记录中获取,扫描图像从图像存档与通信系统中获取。
我们发现6例组织病理学证实为IVM的儿童患者(年龄≤18岁)。本系列患者的平均年龄为14.6岁。在本系列中,肿瘤最常通过顶叶上小叶入路进行处理。所有患者均实现了肿瘤全切。本系列患者的失血量在600-2000毫升之间,平均为1100毫升。组织病理学检查显示所有肿瘤均为1级脑膜瘤。过渡型脑膜瘤是最常见的组织学亚型。在最后一次随访时,所有患者均未复发。
儿童IVM是罕见肿瘤。与成人脑膜瘤以女性居多不同,儿童IVM往往以男性居多。根据肿瘤位置,顶枕经皮质、经胼胝体入路,颞中/下回入路是处理此类肿瘤的所述技术。手术医生在手术过程中应注意大量失血情况,尤其是通过顶枕经皮质入路时。