Pediatric Meningiomas- A Case Report and Review of the Literature_ Crimson Publishers
Pediatric Meningiomas- A Case Report and Review of the Literature by Adrian
Kelly*, Tshepang Tau and Tshilidzi Sidiki in Crimson Publishers: Annals of
Medicine and Surgery
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Background: Pediatric meningiomas are relatively rare accounting for only 3%
of intracranial neoplasms. As such most of the literature on pediatric
meningiomas exists in the form of isolated case reports or as a case series
with small patient numbers. Despite this scarcity of literature several
important features distinguish pediatric
meningiomas from those that occur in adults. These include unique risk
factors; a male predominance; larger tumor sizes at presentation; unusual sites
of occurrence including intraventricular and parenchymal; higher World Health
Organization histological grades; more aggressive clinical behavior and an
increased tendency for recurrence. We present a 12-year-old male patient whom
presented to our unit with a left fronto-parietal convexity meningioma of an
alarming size.
Methods: A 12-year-old male patient presented to our unit with an
eight-month history of a progressive headache complicated by a two-week history
of vomiting. He also complained of progressive weakness of the right side of
his body which had worsened to a point that he was no longer independently
ambulant. General examination revealed craniomegaly with tortuous scalp veins.
Neurological examination revealed a right upper motor neuron facial nerve palsy
and a right hemiplegia of 2/5. Radiological investigation revealed an extremely
large left fronto-parietal
dural based space-occupying lesion which crossed the midline. Due to the
adolescent’s progressive neurology he was taken to the operating room for
emergency resection of the lesion. Gross total resection was achieved, and
histopathological analysis confirmed the lesion to be a fibroblastic
meningioma.
Result: Post-operatively the patient demonstrated a complete resolution
of his hemiplegia and at three weeks post operatively he was already
independently ambulant with power 4/5 on the previously hemiplegic side.
Conclusion: Despite the notorious features that characterize pediatric
meningiomas, as well as an often-intimidating radiological appearance,
adherence to standard Neurosurgical operating principles has the best chance of
ensuring a successful outcome.
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