Comprehensive analysis of meningioma in the first two decades of life: A systematic review.

PURPOSE: To evaluate the relationship between meningioma histological subtype and tumor site in under-20 year-olds. METHODS: A review of the literature on meningioma during the first 2 decades of life was carried out through a Medline search up to February 2019. To evaluate the adult population, a cross-sectional study was conducted on patients operated on between 2000 and 2014 in a single institution. Exclusion criteria comprised: series reports and papers that lacked detailed description of clinical findings, neuroimaging confirmation of tumor location, and/or at least 5 years' follow-up. RESULTS: One hundred and seven manuscripts were included, for 365 under-20 year-old patients: 200 male, and 164 female. Histopathology found 197 cases (53.9%) of WHO grade I meningioma, with predominance of meningothelial (41.1%) and transitional (30.9%) subtypes; 123 (33.7%) grade II, and 45 (12.3%) grade III. For 65 (18.25%) of the 356 cases, recurrence was documented, with only 24 deaths (6.7%). CONCLUSION: Meningioma in this population presented 2 differences compared to the adult population: male predominance, and high incidence of atypical meningioma. Surgery was the primary treatment. Adjuvant radiotherapy is controversial in the literature.

Neuro-oncological features of spinal meningiomas: Systematic review.

PURPOSE: Review the published data on spinal meningioma (SM) to create a more comprehensive picture of its natural history. METHODS: A review of the published SM literature was carried out through a Medline search up to December 2018. The search using the keyword "spinal meningiomas" returned 248 papers and the parameters analyzed in our present study were examined in those publications. Papers without a detailed description of clinical findings, neuroimaging confirmation of the spinal tumor, minimum follow-up of 5 years, or a clear description of the clinical findings were excluded. RESULTS: In the 24 manuscripts reviewed, 1811 (1450 females/361 males) patients with SM were analyzed. The thoracic spine (1181-64.6%) and cervical spine (394-22.7%) were the more prevalent levels. The psammomatous (27.8%) and meningothelial variants (25.2%) were the most prevalent histopathological subtypes. Gross total resection (Simpson I and II) was achieved in 94.5% of cases and subtotal resection (Simpson III or more) in 5.5%. The tumor recurrence rate was 4.4%, and the mortality rate related to surgery or disease progression was 3%. CONCLUSION: WHO grade I predominance was observed among spinal meningiomas, analogous to intracranial meningiomas. SMs predominated in the thoracic spine. Surgery with gross total resection was achieved in the vast majority of cases, resulting in low recurrence and mortality rates.