Sylvian Fissure Meningioma in Childhood: Report of 3 Cases and Review of the Literature.

OBJECTIVE: Sylvian fissure-based meningioma is a rare occurrence during childhood. We report a small series including 3 such cases, all attached to the arachnoid leaflets of the Sylvian fissure. We present a review of the literature and discuss the impact of possibly effective clinical, imaging, and surgical variables on the outcome. METHODS: In a retrospective chart review of children with intracranial meningioma, we encountered 3 cases with Sylvian fissure meningioma operated within the past 32 years. RESULTS: Two girls, 5 and 7 years old, and 1 boy, 7 years of age, presented with epilepsy, headache, diplopia, and hemiparesis. The duration of illness was 3, 4, and 2 months, respectively. All three tumors were attached to the arachnoid layer of the adjacent Sylvian fissure, and they were not dural based. Gross total resection could be achieved, and no recurrences were encountered after 13, 7, and 2 years. CONCLUSION: We report 3 very rare cases of Sylvian arachnoid-based meningiomas. To our knowledge, this is the study with the longest follow-up period (mean 7.3 years, median 7 years). Even though the overall prognosis of pediatric meningiomas may be worse than that of adult illness, we would like to emphasize that the "rare location" of the Sylvian fissure was not an important factor contributing to the outcome in our children.