P09.01 case series: meningioma in young adult male

Abstract

BACKGROUND: Intracranial meningiomas are most common among patients in their fifth to seventh decade of life, typically found in older women. Meningiomas are rare in children and young adults they represent 1-3% of all intracranial tumors in individuals up to age 20 years and 13.5% of intracranial tumors in the 20-34 age group. Meningioma in young adult male is a rare finding. Management of meningioma is similar between young or older patient. The prognosis is depent on the histology finding and type of resection. This case series was made to report an uncommon case including clinical characteristic and management of meningioma in young adult male. MATERIAL AND METHODS: We reported 2 cases of meningioma in young adult male. The first patient was hospitalized on 2016 and diagnosed with atypical meningioma (WHO grade II). The second patient was hospitalized on 2018 and diagnosed with trantitional meningioma (WHO grade I). RESULTS: First case: 23 y.o male was hospitalized because of severe headache. His physical exam showed weakness of his left side of the body. There was diplopia that significant for bilateral six nerves palsy. Funduscopy examination revealed papil edema in both eyes correlated with his complained of blurry visions. There was no cranial irradiation from his past medical history. Second case, a male 22 y.o was because of decreased of visual acquity progressively since two month before. There was history of throbbing headache in his left head with mild to moderate intensity. On his neurological examination, there was mild weakness in his right body side. Visual acquity on his right and left eyes were 1/300 and 1/60. Bilateral papil edema was found in funduscopy examination. In his past medical history, there was no history of cranial iradiation. Both cases showed similar initial symptoms consist of headache and others neurological deficit. Radiological examination was performed with result leading to meningioma in convexity area in both cases. Craniotomy tumor removal with gross total resection as simpson grade 2 was achieved in both patients. In the second case pre-operative embolization was performed in order to achieve optimal resection. Histopathology examination confirmed as atypical (WHO grade II) in the first case and trantitional Meningioma (WHO grade I) in second case. Follow up imaging post operation showed no residual mass lesion in both patients. There were no further management in these patients. Both of patients showed improvement in their neurologic function and able to activity without restriction in daily living. Serial imaging examination is planned to observe reccurence of the tumor. CONCLUSION: Clinical presentation and management of meningioma in these patients are similar as meningioma commonly. Both of patients showed clinical improvement after craniotomy tumor removal succesfully.