A five year-old child with clear cell petro-clival meningioma: case report with clinical and histopathological long-term follow-up

Publikation: Beitrag in FachzeitschriftFallbericht (Case report)BeigetragenBegutachtung

Beitragende

Abstract

Background: Only a few cases have been previously published about clear cell meningiomas in children, the majority of them in the location of the spine. We describe an unusual case of clear cell meningioma occurring at the petro-clival region in a 5-year-old child. We further seek to determine the impact of several growth factors as well as the AKT1 mutation on the tumor growth pattern. Case presentation: A five-year-old girl was presented with a one-week history of cephalgia, ataxia, and left sided torticollis. Magnetic resonance imaging (MRI) revealed a dumbbell-shaped homogeneously petro-clival gadolinium-enhancing mass. A staged operative approach was chosen, and a complete removal of the tumor was achieved. Due to recurrent tumor progression, the child underwent several tumor surgeries and two cranial radiations. None of the treatments were able to stop tumor progression. Consequently, the child died at the age of 14 after further extensive intracranial and extracranial tumor progression. The initial histological examination revealed a clear cell meningioma WHO grade II with an MIB-1 labeling index of <1 %, which gradually increased with every recurrence up to 10 % by the last progression at the age of 13 years. Analogically, an increasing overexpression of epidermal growth factor receptor (EGFR), the platelet-derived growth factor receptor (PDGFR), and the vascular endothelial growth factor receptor (VEGFR) was observed with each recurrence. The AKT1 (E17K) mutation in the tumor was not detectable in all investigated specimens. Conclusion: Pediatric clear cell meningiomas WHO grade II are very rare. Our data demonstrate the progressive overexpression of EGF-, PDGF-, and VEGF-receptors in each recurrence, providing one of these receptors as targeted therapy in such cases. Further evaluation of these growth factors in clear cell meningioma is required to establish the optimal treatment of these aggressive tumors.

Details

OriginalspracheEnglisch
Seiten (von - bis)2193-2198
Seitenumfang6
Fachzeitschrift Child's nervous system : ChNS ; official journal of the International Society for Pediatric Neurosurgery, European Society for Paediatric Neurosurgery, Korean Society for Pediatric Neurosurgery
Jahrgang31
Ausgabenummer11
PublikationsstatusVeröffentlicht - 1 Nov. 2015
Peer-Review-StatusJa

Externe IDs

researchoutputwizard legacy.publication#67070
researchoutputwizard legacy.publication#67224
researchoutputwizard legacy.publication#67625
Scopus 84945488539
PubMed 26077595

Schlagworte

Schlagwörter

  • AKT1 mutation, Child, Clear cell meningioma, Epidermal growth factor receptor, Platelet-derived growth factor receptor, Vascular endothelial growth factor receptor