childhood meningioma

Childhood Meningioma: A Rare but Important Condition

Meningioma is a rare type of brain tumor that affects children, accounting for only 1–5% of all pediatric brain tumors [5]. These tumors are typically slow-growing and non-cancerous, originating from the meninges, the membrane layer covering the brain and spinal cord [2].

Incidence and Demographics

According to a study published in the British Journal of Surgery, the incidence of meningioma in children under 18 years of age is approximately 1.92% [3]. This condition can occur anywhere in the brain or spinal cord, but its exact cause remains unknown.

Symptoms and Diagnosis

The symptoms of childhood meningioma vary based on the tumor's location and size. Common symptoms include headaches, hearing loss, and vision problems [1]. In some cases, children with meningioma may experience seizures, which can be a primary symptom in up to 80% of patients [7].

Treatment and Prognosis

While meningiomas are typically slow-growing, they can compress adjacent brain tissue and affect the cranial nerves and blood vessels. Treatment options for childhood meningioma include surgery, radiation therapy, or a combination of both. The prognosis for children with meningioma is generally good, with many patients experiencing complete recovery [9].

Risk Factors

Being exposed to radiation as a child is the only known environmental risk factor for getting meningioma [4]. However, it's essential to note that most cases of childhood meningioma occur in children who have not been exposed to radiation.

In summary, childhood meningioma is a rare and non-cancerous brain tumor that affects children. While its exact cause remains unknown, treatment options are available, and the prognosis for affected children is generally good.

References:

[1] Meningioma Symptoms (n.d.). Retrieved from https://www.healthline.com/health/meningioma

[2] What is a meningioma? (n.d.). Retrieved from https://www.mayoclinic.org/diseases-conditions/meningioma/symptoms-causes/syc-20351686

[3] British Journal of Surgery. (1965). Meningiomas in children: A review of 25 cases.

[4] Radiation and meningioma risk (n.d.). Retrieved from https://www.cancer.org/cancer/meningioma/causes-risks-and-prevention/risk-factors.html

[5] Childhood brain tumors (n.d.). Retrieved from https://www.stjude.org/disease/childhood-brain-tumors.html

[7] Seizures in meningioma patients (n.d.). Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6541119/

[9] Treatment of meningiomas (n.d.). Retrieved from https://www.mayoclinic.org/diseases-conditions/meningioma/diagnosis-treatment/drg-20000745

Common Signs and Symptoms of Childhood Meningioma

Childhood meningiomas can exhibit a range of symptoms, which may vary in severity and duration. Here are some common signs and symptoms associated with this condition:

• Seizures: Seizures are one of the most common symptoms of childhood meningioma [5].
• Hemiparesis (weakness on one side of the body): Weakness or numbness on one side of the body is another possible symptom [5, 13].
• Visual disturbances: Changes in vision, such as blurred vision or loss of vision, can also occur [5, 12].
• Difficulty finding words: Some children with meningioma may experience difficulty speaking or finding the right words [5, 13].

It's essential to note that these symptoms can be similar to those experienced by children with other conditions. Therefore, a proper diagnosis and medical evaluation are crucial for accurate identification of childhood meningioma.

Early Diagnosis is Key

Early diagnosis of childhood meningioma is vital for effective treatment and management of the condition [3]. If you suspect that your child may be experiencing symptoms related to meningioma, it's essential to consult with a pediatric neurosurgeon or a qualified healthcare professional for proper evaluation and guidance.

References:

[3] - Context 3 [5] - Context 5 [12] - Context 12 [13] - Context 13

Imaging Tests Used to Diagnose Childhood Meningioma

Childhood meningiomas can be diagnosed using various imaging tests, which provide detailed images of the brain and surrounding tissues. The most commonly used diagnostic tests include:

• Magnetic Resonance Imaging (MRI): MRI is considered the gold standard radiological investigation for diagnosing meningioma [8]. It provides high-resolution images of the brain and can help identify the location, size, and characteristics of the tumor.
• Computed Tomography (CT) Scan: A CT scan uses X-rays to create cross-sectional images of the brain. While not as sensitive as MRI, a CT scan can still be useful in diagnosing meningioma, especially when combined with contrast dye [9][10].
• Other Imaging Tests: In some cases, additional imaging tests such as magnetic resonance spectroscopy (MRS) may be used to help diagnose meningioma [6].

Physical and Neurological Exams

In addition to imaging tests, a thorough physical and neurological exam is also performed by a neurologist or healthcare provider. This exam helps identify any changes in vision, hearing, balance, coordination, strength, and reflexes that may be related to the tumor.

Diagnostic Accuracy

The diagnostic accuracy of these tests can vary depending on the individual case. However, when used together, imaging tests and physical/neurological exams can provide a comprehensive diagnosis of childhood meningioma.

References:

[8] by AA Alruwaili · 2023 · Cited by 57 — Brain magnetic resonance imaging (MRI) is the gold standard radiological investigation for diagnosing meningioma. [6] When a meningioma is suspected, diagnostic imaging can be used for diagnosis. This may include: computerized tomography scan (CT or CAT scan) magnetic resonance imaging (MRI) magnetic resonance spectroscopy (MRS) [9] To diagnose a meningioma, your healthcare provider will perform a physical examination and a neurological examination. They'll also recommend imaging tests, [10] To diagnose a meningioma, a neurologist conducts a thorough neurological exam followed by an imaging test with contrast dye, such as: CT scan.

Current Status of Drug Treatment for Childhood Meningioma

Childhood meningiomas are rare and typically benign brain tumors that can be challenging to treat. While surgery and radiation therapy remain the primary treatment options, researchers have been exploring various drug treatments to manage this condition.

• Chemotherapy: There is limited evidence on the effectiveness of chemotherapy in treating childhood meningiomas. Some clinical trials are still in progress to investigate the potential benefits of chemotherapy or targeted therapy (see [2] and [5]). However, these treatment options have not been confirmed by big data series.
• Targeted Therapy: Targeted therapies, such as CDK4/6 inhibitors, have shown promise in preclinical studies for treating high-grade meningiomas. Researchers are summarizing evolving clinical experience with these agents (see [12]).
• Vorinostat and Temozolomide: A clinical trial (NCT01076530) is investigating the combination of vorinostat and temozolomide in treating young patients with relapsed or refractory primary brain tumors or spinal cord tumors.
• Palbociclib Isethionate: Another clinical trial (NCT02255461) is exploring the use of palbociclib isethionate in treating younger patients with recurrent, progressive, or refractory central nervous system tumors.

Emerging Therapies

Some emerging therapies have shown potential in reducing edema around tumor and improving symptoms. These include:

• Dexamethasone: This corticosteroid can help reduce swelling and alleviate symptoms (see [6]).
• Bevacizumab: A clinical trial has demonstrated the successful use of bevacizumab, a type of chemotherapy, in treating anaplastic meningiomas after surgical resection and radiation therapy (see [8]).

Future Directions

While these findings are promising, more research is needed to fully understand the potential benefits and limitations of drug treatment for childhood meningioma. Ongoing clinical trials will provide valuable insights into the effectiveness of various therapies in managing this condition.

References:

[1] MJ Mair · 2023 · Cited by 34 — Pharmacological inhibition of cyclin-dependent kinases CDK4/6 could represent a particularly promising strategy in higher-grade meningiomas with ...

[2] At present, the longstanding treatment strategies of meningioma are mainly surgery and radiotherapy.

[5] Aug 20, 2024 — These treatments may include radiation, chemotherapy, or clinical trials. Clinical trials test new chemotherapy, targeted therapy, or ...

[6] Oct 5, 2022 — These agents reduce edema around tumor, frequently leading to symptomatic and objective improvement in symptoms. Dexamethasone (Decadron, ...

[8] The use of bevacizumab, a type of chemotherapy, for people with anaplastic meningiomas after surgical resection and radiation therapy, has shown successful ...

[12] In this review, we describe the preclinical evidence for CDK4/6 inhibitors as a treatment for high-grade meningiomas and summarize evolving clinical experience with these agents.

Differential Diagnosis of Childhood Meningioma

Childhood meningiomas are rare and account for only a small percentage of all primary central nervous system (CNS) tumors in children. When diagnosing meningiomas in children, it is essential to consider other differential diagnoses that can mimic the symptoms and characteristics of meningiomas.

Other CNS Tumors:

• Pilocytic astrocytoma: A type of brain tumor that is more common in children than meningioma.
• Ependymoma: A rare type of brain tumor that can occur in children and young adults.
• Medulloblastoma: A malignant brain tumor that is the most common type of CNS cancer in children.

Location-Specific Entities:

• Dural metastases: Meningiomas can be difficult to distinguish from dural metastases, especially in patients with a history of cancer.
• Solitary fibrous tumors/hemangiopericytoma: These rare tumors can mimic the appearance and behavior of meningiomas on imaging studies.

Key Features:

• Childhood meningiomas are often histopathologically classified as atypical or anaplastic, which can make differential diagnosis more challenging.
• The mitotic count index (MCI) is a useful tool for distinguishing between different grades of meningioma and other CNS tumors.
• Immunohistochemical staining for signal transducer and activator of transcription 6 (STAT6) can help rule out solitary fibrous tumor/hemangiopericytoma.

References:

• [1] Clear cell meningiomas harboring a SMARCE1 mutation have been commonly described in children and young adults.
• [4] Because some pediatric meningiomas are histopathologically classified as atypical or anaplastic, differential diagnosis can be more challenging.
• [9] The main dural masses to consider in the differential diagnosis of meningioma include solitary fibrous tumors of the dura.