Abstract
Spontaneous intratumoral hemorrhage secondary to meningioma in a child is rarely encountered. Here, we report a very rare case of anaplastic meningioma with intratumoral hemorrhage presenting with rapid neurological deterioration in a child. A 3-year-old boy with a large anaplastic meningioma presented with mild left hemiparesis. Magnetic resonance imaging (MRI) showed a giant tumor in the right frontal lobe with heterogeneous intensity associated with intratumoral hemorrhage. Contrast-enhanced fast imaging employing steady-state acquisition (FIESTA) showed that the tumor was attached to the falx and extended to the contralateral side. On the day after admission, the patient's consciousness level rapidly deteriorated, and he underwent emergency surgery. The tumor attached to the falx was completely removed with dural attachment. The tumor was histologically diagnosed as anaplastic meningioma. Two months after the surgery, MRI showed tumor recurrence. The tumor was extensively removed again, and the patient underwent radiotherapy. Eight months after the initial operation, the patient showed no neurological deficits. No tumor recurrence was detected on follow-up MRI. The epidemiological, prognostic, and therapeutic features of pediatric meningiomas are poorly defined because of its rarity. We present this rare case to emphasize the necessity of close observation of MRI after an aggressive surgery of anaplastic meningioma in children and highlight the importance of surgery and irradiation once recurrence has been detected.
