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CC BY 4.0 · Surg J (N Y) 2016; 02(02): e31-e36
DOI: 10.1055/s-0036-1584166
Review Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Pediatric Meningeal Tumors of the Sylvian Fissure Region without Dural Attachment: A Series of Three Patients and Review of the Literature

Daniel Joseph Donovan
1   Department of Surgery, University of Hawaii–John A. Burns School of Medicine, Honolulu, Hawaii
,
Varoon Thavapalan
2   Department of Neurological Surgery, Thomas Jefferson University Hospitals, Philadelphia, Pennsylvania
› Author Affiliations
Further Information

Publication History

23 October 2015

24 March 2016

Publication Date:
26 May 2016 (online)

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Abstract

Pediatric meningeal tumors are rare, but those in the region of the sylvian fissure without dural attachment are extremely rare, with only 24 previously reported cases in the world literature. In this series, we report two additional cases of sylvian fissure meningioma without dural attachment and one case of perisylvian meningioangiomatosis in the medial temporal lobe. All three patients presented with complex partial seizures, but the diagnosis was delayed in each case because the symptoms were misinterpreted to be behavioral rather than epileptic. The seizures were eventually confirmed with electroencephalogram, and subsequent imaging showed enhancing masses within the sylvian fissure region that were at least partially calcified in all three cases. Each patient underwent craniotomy. In the first case, gross total resection was achieved, and in the second case, a small residual portion of tumor was densely calcified and adherent to the middle cerebral artery branches. Both of these were World Health Organization (WHO) grade I meningiomas. The third patient underwent biopsy and limited resection of meningioangiomatosis. No dural attachments were noted in any of the tumors, but one of the meningiomas was intraparenchymal in location, surrounding the sylvian fissure in both the frontal and temporal lobes, which has been described in only a small number of these cases previously. The patients underwent pre- and postsurgical neuropsychiatric testing and did not experience any significant cognitive deficits. At 10-year follow-up, the patient who had gross total resection of the tumor has had no recurrence and is seizure-free without anticonvulsant medications. The incompletely resected intraparenchymal meningioma in the second patient recurred after 5 years, however, and at repeat surgery was found to have transformed to a WHO grade II tumor. Radiation therapy was delivered and the tumor has been stable for 2 years, but the patient continues to have occasional seizures despite medication. The patient with meningioangiomatosis has had no further growth and has excellent control of seizures but remains on medication. We review the clinical presentation of these rare tumors and discuss the treatment, outcomes, and possible relationship of meningiomas to meningioangiomatosis.

Keywords

pediatric tumors - meningeal tumors - sylvian fissure meningioma - seizures
 

  • References

  • 1 Drake JM, Hendrick EB, Becker LE, Chuang SH, Hoffman HJ, Humphreys RP. Intracranial meningiomas in children. Pediatr Neurosci 1985; –1986 12 (03) 134-139
    CrossrefPubMedGoogle Scholar
  • 2 Doty JR, Schut L, Bruce DA, Sutton LN. Intracranial meningiomas of childhood and adolescence. Prog Exp Tumor Res 1987; 30: 247-254
    PubMedGoogle Scholar
  • 3 Liu Y, Li F, Zhu S, Liu M, Wu C. Clinical features and treatment of meningiomas in children: report of 12 cases and literature review. Pediatr Neurosurg 2008; 44 (02) 112-117
    CrossrefPubMedGoogle Scholar
  • 4 Gao X, Zhang R, Mao Y, Wang Y. Childhood and juvenile meningiomas. Childs Nerv Syst 2009; 25 (12) 1571-1580
    CrossrefPubMedGoogle Scholar
  • 5 Silbergeld D, Berger M, Griffin B. Sylvian fissure meningioma in a child: case report and review of the literature. Pediatr Neurosci 1988; 14 (01) 50-53
    CrossrefPubMedGoogle Scholar
  • 6 Cho BK, Wang KC, Chang KH, Chi JG. Deep sylvian meningioma in a child. Childs Nerv Syst 1990; 6 (04) 228-230
    CrossrefPubMedGoogle Scholar
  • 7 Mori Y, Shibuya M, Sugita K, Nagasaka T. [Deep sylvian meningioma: a case report of a child]. No Shinkei Geka 1994; 22 (12) 1147-1151
    PubMedGoogle Scholar
  • 8 Chiocca EA, Boviatsis EJ, Westmark RM, Short MP, Richardson EP, Zevras NT. Deep sylvian meningioma without dural attachment in an adult: case report. Neurosurg 1994; 35 (05) 944-946 , discussion 946
    CrossrefPubMedGoogle Scholar
  • 9 Cooper JR, Marshman LAG, Smith CML, Powell T. Case report: sylvian fissure meningioma without dural attachment in a 4-year-old child. Clin Radiol 1997; 52 (11) 874-876
    CrossrefPubMedGoogle Scholar
  • 10 Mitsuyama T, Kasuya H, Kubo O, Hirasawa K, Hori T. [Left sylvian fissure meningioma in a one-year-eight-month old child]. No Shinkei Geka 2000; 28 (05) 459-464
    PubMedGoogle Scholar
  • 11 Kaplan SS, Ojemann JG, Park TS. Pediatric sylvian fissure meningioma. Pediatr Neurosurg 2002; 36 (05) 275-276
    CrossrefPubMedGoogle Scholar
  • 12 Cooper WA, Shingde M, Lee VK, Allan RS, Wills EJ, Harper C. “Rhabdoid meningioma” lacking malignant features. Report of two cases. Clin Neuropathol 2004; 23 (01) 16-20
    PubMedGoogle Scholar
  • 13 Chang JH, Kim JA, Chang JW, Park YG, Kim TS. Sylvian meningioma without dural attachment in an adult. J Neurooncol 2005; 74 (01) 43-45
    CrossrefPubMedGoogle Scholar
  • 14 McIver JI, Scheithauer BW, Atkinson JL. Deep sylvian fissure chordoid meningioma: case report. Neurosurgery 2005; 57 (05) E1064 , discussion E1064
    CrossrefPubMedGoogle Scholar
  • 15 Eghwrudjakpor PO, Mori K. Sylvian cleft meningioma: surgical approach and postoperative morbidity. Niger J Med 2006; 15 (04) 437-440
    PubMedGoogle Scholar
  • 16 Zhang J, Chi LY, Meng B, Li F, Zhu SG. Meningioma without dural attachment: case report, classification, and review of the literature. Surg Neurol 2007; 67 (05) 535-539
    CrossrefPubMedGoogle Scholar
  • 17 Samson Sujit Kumar G, Rajshekhar V. Deep sylvian meningioma: a case report and review of literature. Childs Nerv Syst 2009; 25 (01) 129-132
    CrossrefPubMedGoogle Scholar
  • 18 Zheng J, Wang S, Zhao JZ, Cao Y. [Diagnosis and surgical treatment of intraparenchymal sylvian fissure meningioma]. Zhonghua Yi Xue Za Zhi 2009; 89 (33) 2353-2355
    PubMedGoogle Scholar
  • 19 Cecchi PC, Campello M, Rizzo P, Mair K, Schwarz A. Atypical meningioma of the sylvian fissure. J Clin Neurosci 2009; 16 (09) 1234-1239
    CrossrefPubMedGoogle Scholar
  • 20 Miyahara K, Ichikawa T, Yagishita S. , et al. [Deep sylvian meningioma without dural attachment: a case report]. No Shinkei Geka 2011; 39 (11) 1067-1072
    PubMedGoogle Scholar
  • 21 Ma L, Xiao SY, Zhang YK. Atypical meningioma of sylvian fissure with a 20-year history: a rare case report. Neurol Sci 2012; 33 (01) 143-145
    CrossrefPubMedGoogle Scholar
  • 22 Aras Y, Akcakaya MO, Aydoseli A, Izgi N. Staged surgery for sylvian fissure meningiomas without dural attachment: report of two cases. Clin Neurol Neurosurg 2013; 115 (08) 1527-1529
    CrossrefPubMedGoogle Scholar
  • 23 Fukushima S, Narita Y, Yonezawa M. , et al. Short communication: sclerosing meningioma in the deep sylvian fissure. Brain Tumor Pathol 2014; 31 (04) 289-292
    CrossrefPubMedGoogle Scholar
  • 24 Omeis I, Hillard VH, Braun A, Benzil DL, Murali R, Harter DH. Meningioangiomatosis associated with neurofibromatosis: report of 2 cases in a single family and review of the literature. Surg Neurol 2006; 65 (06) 595-603
    CrossrefPubMedGoogle Scholar
  • 25 Wang Y, Gao X, Yao ZW. , et al. Histopathological study of five cases with sporadic meningioangiomatosis. Neuropathology 2006; 26 (03) 249-256
    CrossrefPubMedGoogle Scholar
  • 26 Arcos A, Serramito R, Santín JM. , et al. Meningioangiomatosis: clinical-radiological features and surgical outcome. Neurocirugia (Astur) 2010; 21 (06) 461-466
    PubMedGoogle Scholar
  • 27 Chen YY, Tiang XY, Li Z, Luo BN, Huang Q. Sporadic meningioangiomatosis-associated atypical meningioma mimicking parenchymal invasion of brain: a case report and review of the literature. Diagn Pathol 2010; 5: 39
    CrossrefPubMedGoogle Scholar
  • 28 Perry A, Kurtkaya-Yapicier O, Scheithauer BW. , et al. Insights into meningioangiomatosis with and without meningioma: a clinicopathologic and genetic series of 24 cases with review of the literature. Brain Pathol 2005; 15 (01) 55-65
    PubMedGoogle Scholar
  • 29 Rokes C, Ketonen LM, Fuller GN, Weinberg J, Slopis JM, Wolff JE. Imaging and spectroscopic findings in meningioangiomatosis. Pediatr Blood Cancer 2009; 53 (04) 672-674
    CrossrefPubMedGoogle Scholar
  • 30 Yao Z, Wang Y, Zee C, Feng X, Sun H. Computed tomography and magnetic resonance appearance of sporadic meningioangiomatosis correlated with pathological findings. J Comput Assist Tomogr 2009; 33 (05) 799-804
    CrossrefPubMedGoogle Scholar
  • 31 Jallo GI, Kothbauer K, Mehta V, Abbott R, Epstein F. Meningioangiomatosis without neurofibromatosis: a clinical analysis. J Neurosurg 2005; 103 (4, Suppl): 319-324
    PubMedGoogle Scholar
  • 32 Deb P, Gupta A, Sharma MC, Gaikwad S, Singh VP, Sarkar C. Meningioangiomatosis with meningioma: an uncommon association of a rare entity—report of a case and review of the literature. Childs Nerv Syst 2006; 22 (01) 78-83
    CrossrefPubMedGoogle Scholar
  • 33 Saad A, Folkerth R, Poussaint T, Smith E, Ligon K. Meningioangiomatosis associated with meningioma: a case report. Acta Cytol 2009; 53 (01) 93-97
    CrossrefPubMedGoogle Scholar
  • 34 Kim NR, Cho SJ, Suh YL. Allelic loss on chromosomes 1p32, 9p21, 13q14, 16q22, 17p, and 22q12 in meningiomas associated with meningioangiomatosis and pure meningioangiomatosis. J Neurooncol 2009; 94 (03) 425-430
    CrossrefPubMedGoogle Scholar