A clinicopathological analysis of 87 cases of meningioma in children and adolescents age 5 months to 20 years (mean 14 years) is reported from the Armed Forces Institute of Pathology, Walter Reed Army Medical Center, Children’s National Medical Center, George Washington University, Washington, DC; Uniformed University of Health Sciences, Bethesda, MD; and Catholic University of Korea, Seoul. Males outnumbered females, 52 to 35. Presenting symptoms were seizures in 33%, headaches (13%), ataxia (10%), and hemiparesis (10%). Neurofibromatosis type 2 was present in 9 patients and Gorlin syndrome (multiple basal cell carcinoma syndrome, a familial autosomal-dominant inheritance) in 2. Tumors were supratentorial in 64%, inffatentorial in 16%, intraventricular in 12%, and spinal in 8%. Total resection was performed in 53 (62%) patients, and subtotal resection in 28 (33%). Seven had received radiotherapy. Recurrences occurred in 12. Meningiomas were WHO Grade I in 62 (71%), Grade II in 21 (24%), and Grade III in 4 (5%). At a median follow-up of 68.5 months in 62 patients, 7 (11.3%) had died. Recurrence-free survival time was significantly related to WHO grade (33% of Grade III cases survived 10 years cf 70% and 92% for Grade I and II cases; p=0.002). Except for weak evidence of a higher risk in Grade III tumors (50% with 5 year survival cf to 97% and 100% for Grade I and II, respectively), overall survival time was not significantly linked to WHO grade or other prognostic factor (p=0.06). 
COMMENT. Close surveillance is advisable in children who have undergone radiotherapy or have a genetic predisposition to meningioma. Childhood meningiomas account for less than 3% of primary CNS tumors.