Children's Cancer and Leukaemia Group (CCLG): guidelines for the management of intracranial meningioma in children and young people.

Primary tumours of the meninges occur extremely rarely in children and young people (less than five new cases annually in the UK) and have remained a poorly defined group compared with the common diagnosis of meningiomas in adults. Because of the rarity in children, paediatric meningiomas are often treated according to the adult practice. This may lead to inappropriate treatment considerations since paediatric meningiomas exhibit peculiarities that distinguish them from their adult counterpart. Striking the balance between late toxicities of adjuvant radiotherapy on the growing brain versus the risk of repeated recurrences necessitating surgical interventions in young patients is of importance and will require a clinical decision making process in the paediatric neuro-oncological/neurosurgical MDT tailored to each patient's age and clinical setting. The paediatric literature is based on small, single institution retrospective studies over extensive time periods during which the imaging facilities, pathological criteria and surgical advances have led to shifts in definitions of disease making comparison of results difficult to interpret. These guidelines have been developed following a comprehensive appraisal of the literature. Primary treatment is surgical resection. Careful pathological review and multidisciplinary discussions should be undertaken before considering postoperative treatment, such as radiotherapy for histologically anaplastic or clinically aggressive, relapsing meningioma.