Intracranial meningiomas in individuals under the age of 30; Analysis of risk factors, histopathology, and recurrence rate

Background: Intracranial meningiomas are rare in individuals under age 30 years. The purpose of this study was to analyze the demographics and clinical features of intracranial meningiomas in individuals under age 30 years. Methods: A retrospective analysis of clinical, radiographic, and pathology data of patients under age 30 years who presented with an intracranial meningioma was performed. Results: Thirty five patients met the criteria. Mean age was 25 years, 11 were male and 24 female. Five patients had previous radiation exposure. The presenting symptom was headache in 16 patients (45.7%) and seizure in 9 (25.7%). Cranial base tumors comprised 74%; 26% were supratentorial. Simpson grade 1 or 2 resection was achieved in 16 patients (48.5%); grade 3 or 4 resection was achieved in 17 patients (51.5%). Tumor pathologic grade was WHO grade I in 27 (77.1%), grade II in 6 (17.1%) and grade III in 2 patients (5.7%). Postoperative radiation therapy for tumor progression was administered in 13 patients. Radiographic follow-up was available in 26 patients at an average of 6.1 years after surgery; of these, 14 had no recurrence or progression of residual tumor while 12 had recurrence or progression. Recurrence was more common in patients with WHO grade II and III tumors and radiation-induced meningiomas. Recurrent tumors tended to have a higher WHO grade. Conclusion: In this group of intracranial meningiomas in individuals <30 years, ionizing radiation was a risk factor and tumors were more common in females. A higher percentage of WHO grade II and III tumors at presentation and recurrence was noted. Recurrent tumors were more common in patients with higher WHO grade and in radiation-induced meningiomas.