J Korean Neurosurg Soc.  2012 Apr;51(4):219-221. 10.3340/jkns.2012.51.4.219.

Meningioma in a 20-Month-Old Boy

• Jung YS
• Song YJ

• KMID: 2066914
• DOI: http://doi.org/10.3340/jkns.2012.51.4.219

Abstract

A 20-month-old boy presented with a intraparenchymal mass in the right frontoparietal area manifesting as complex partial seizure, secondary generalization and left hemiparesis. Magnetic resonance images (MRI) of the brain showed inhomogeneously enhancing mass in the right frontoparietal area which has irregular margin and perilesional edema. Based on the radiological findings, a preoperative diagnosis was an intraaxial tumor, such as pilocytic astrocytoma or dysembryoplastic neuroepithelial tumor. The patient underwent a surgery including frontal craniotomy. The tumor had a partially extreme adherence to the surrounding brain tissue but it showed no dural attachment. Gross-total resection of the tumor was achieved. Postoperative follow-up computed tomography scans showed no residual tumor. The pathological findings confirmed the tumor as a WHO grade I meningioma, transitional type. Nine months after the surgery, follow-up brain MRI showed no recurrence of the tumor, porencephaly in site where the tumor was resected; the patient's symptoms had fully recovered. We report the case of a meningioma in a 20-month-old boy.

Keyword

Meningioma; Children

MeSH Terms

Astrocytoma
Brain
Child
Craniotomy
Edema
Follow-Up Studies
Generalization (Psychology)
Humans
Infant
Magnetic Resonance Spectroscopy
Meningioma
Neoplasm, Residual
Neoplasms, Neuroepithelial
Paresis
Recurrence
Seizures

Figure

• 

  Fig. 1 Preoperative magnetic resonance images, showing a tumor as a 4-cm-sized mass with an irregular margin and peritumoral edema in right frontoparietal area. The tumor shows a high signal intensity on axial T1-weighted image (A), an iso signal intensity on axial T1-weighted image (B), and it showed inhomogenous enhancement on an coronal T1-enhanced spin echo image (C).

• 

  Fig. 2 After the dura mater was opened, the tumor was seen to be partially extreme adhered to the surrounding brain tissue but it had no dural attachment. Since the tumor originated from the parenchyme, it was designated as an intra-axial tumor (A). The intraparenchymal tumor located in right frontoparietal area was removed (B). After the tumor was removed, intraparenchymal tumor bed was seen (C).

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  Fig. 3 Histopathological findings of the tumor showing mixed patterns of lobular meningothelial cells and fibrous spindle cells forming parallel bundles and occasional psammoma bodies (arrow) (A and B). Immunohistochemical finding show that the tumor cells are positive for vimentin (C) and focal positive for epithelial membrane antigen (D). On the basis of these findings, it was concluded that the tumor was WHO grade I meningioma of the transitional type.

• 

  Fig. 4 Follow-up brain magnetic resonance image (MRI) obtained 9 months after the surgery does not show any recurrence of the tumor, porencephaly in a site where the previous tumor was resected. The MRI showed irregular brain defect in right posterior frontal area on an axial T2-weighted image (A), on an axial T1-weighted image (B), and it showed no abnormal enhancement on an coronal T1-enhanced spin echo image (C).

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