Long-term follow up of children with meningiomas in Denmark: 1935 to 1984.

OBJECT: Meningiomas in children are rare, infrequently described in the literature, and often associated with neurofibromatosis Type 2 (NF2). The authors report a series of 22 children treated for an intracranial meningioma in Denmark between 1935 and 1984.
METHODS: Of 1542 cases of pediatric intracranial tumors in children younger than 15 years of age, 22 harbored meningiomas. Three children suffered from NF. The male/female ratio was 8:14. The mean age at the time of diagnosis was 5 years for boys and 11.5 years for girls. At the time of diagnosis all tumors were large. All patients underwent surgery. In 20 cases, the final histological diagnoses were low-grade and in two cases high-grade tumors. The follow-up period ranged from I to 45 years (mean 16 years). Two patients were lost to follow up. Four of seven boys and three of 13 girls survived. Five of 13 children in whom the tumor was completely removed survived, whereas two of seven in whom the lesion was partially removed survived. The mean survival time in children who died during follow up was 10 years. Two children with anaplastic meningioma remain alive.
CONCLUSIONS: The long-term prognosis for surgically treated children with intracranial meningiomas was worse than expected. Some reasons for this may have been the late diagnosis and related large size of the tumor during a period of limited diagnostic capacity prior to the computerized tomography and magnetic resonance imaging eras, and the association of NF2 with multiple tumors of the central nervous system. Complete resection is not always possible and should be performed as an image-guided operation.