Meningiomas in childhood.

Meningiomas are rare intracranial neoplasms in the pediatric population. Most of the reports concerning these tumors have stressed some distinguishing features comparable with the adult counterpart. Besides the lower incidence, the nearly equal sex distribution, the relatively common infratentorial location and the frequent development within the ventricular system have been emphasized. A poor prognosis of pediatric meningiomas has also been claimed by authors who have suggested that this could be owing to a possibly more aggressive behavior, accounting for the huge size that these tumors have usually reached at diagnosis, the difficult surgical excision, and the higher recurrence rate. The analysis of recent series challenges the concept that pediatric meningiomas do actually bear a worse prognosis than similar tumors occurring in older patients. Improved surgical techniques have in fact resulted in higher percentages of complete tumor removal. Better histological delineation has allowed the identification of highly aggressive meningeal neoplasms, which in the past were not differentiated properly, thus contributing to the apparent higher incidence of recurrent tumors in the pediatric population. When the studies are limited to the "classical" form of meningioma, it becomes apparent that pediatric meningiomas do not behave more aggressively than meningiomas in adult patients.