Hong Sukwoo, Usami Kenichi, Hirokawa Daisuke, Ogiwara Hideki
Division of Neurosurgery, National Center for Child Health and Development, Tokyo, Japan.
, Setagaya-ku, Japan.
Childs Nerv Syst. 2019 Nov;35(11):2219-2225. doi: 10.1007/s00381-019-04142-y. Epub 2019 Apr 18.
The purpose of this paper is to provide novel insight into the rare pediatric meningiomas.
We retrospectively analyzed pediatric surgical cases of meningioma during 2002 to 2017 in our institution. The preoperative, intraoperative, and the postoperative status were collected to find any unique features that has not reported in the past.
Nine surgeries out of 5 patients were identified. The mean age was 7 years old (range 1-14 years old). Four patients were females. The mean tumor diameter was 52 mm (range 23-81 mm). The tumor locations were optic nerve sheath, Sylvian fissure, parasagittal, trigone of the lateral ventricle, and cerebellopontine angle. The Sylvian fissure meningioma without dural attachment (MWODA) was found in a 15-month-old female. A relapsed parasagittal meningioma showed regression in histological grade and residual tumor demonstrated spontaneous regression. In the initial surgeries, Simpson grade 1 resection was achieved in 2 cases. The pathological diagnoses were 1 meningothelial, 1 metaplastic, 2 atypical, and 1 clear cell meningiomas. The mean postoperative follow-up period was 71 months. Three patients experienced recurrence of the tumor. At the latest follow-up, all patients were free of radiological tumor recurrence or regrowth with a mean follow-up of 4 years (range 1-6.9 years). All patients were in the modified Rankin scale of 0-1.
MWODA is not considered to be rare in pediatric meningioma and should be included in the differential diagnosis. We presented a histologically regressed relapsed meningioma, which spontaneously regressed after subtotal resection. In the case of recurrent meningioma, surgical resection and adjuvant radiation therapy could be effective for long-term control of the tumor.
本文旨在为罕见的儿童脑膜瘤提供新的见解。
我们回顾性分析了2002年至2017年我院儿童脑膜瘤的手术病例。收集术前、术中和术后情况,以发现过去未报道的任何独特特征。
共识别出5例患者的9次手术。平均年龄为7岁(范围1 - 14岁)。4例为女性。平均肿瘤直径为52毫米(范围23 - 81毫米)。肿瘤位置为视神经鞘、外侧裂、矢状窦旁、侧脑室三角区和桥小脑角。在一名15个月大的女性中发现了无硬脑膜附着的外侧裂脑膜瘤(MWODA)。一例复发性矢状窦旁脑膜瘤组织学分级出现退变,残留肿瘤显示自发消退。在初次手术中,2例实现了辛普森1级切除。病理诊断为1例脑膜内皮型、1例化生型、2例非典型型和1例透明细胞型脑膜瘤。术后平均随访期为71个月。3例患者出现肿瘤复发。在最近一次随访时,所有患者在平均4年(范围1 - 6.9年)的随访中均无影像学上的肿瘤复发或生长。所有患者改良Rankin量表评分为0 - 1分。
MWODA在儿童脑膜瘤中并非罕见,应纳入鉴别诊断。我们报告了一例组织学退变的复发性脑膜瘤,在次全切除后自发消退。对于复发性脑膜瘤,手术切除和辅助放疗可能对肿瘤的长期控制有效。