Pediatric Meningiomatosis: A Rare Radiological Case Report

Abstract

Meningiomatosis is defined as the presence of multiple synchronous meningiomas arising at separate intracranial or spinal locations in the absence of prior cranial irradiation. While meningiomas represent one of the most common extra-axial intracranial tumors in adults, they are rare in children, accounting for less than 3% of pediatric central nervous system tumors. Pediatric meningiomatosis is exceedingly uncommon, with only sporadic cases reported, and its true incidence remains unknown.

Diagnosis relies primarily on neuroimaging, with magnetic resonance imaging (MRI) serving as the modality of choice. Typical MRI features include multiple well-defined extra-axial masses that are isointense to gray matter on T1-weighted images, iso- to hyperintense on T2-weighted and fluid-attenuated inversion recovery sequences, and demonstrate strong, usually homogeneous contrast enhancement with broad-based dural attachment and dural tail signs. Diffusion-weighted imaging generally shows no significant diffusion restriction, supporting a benign etiology.

We report a rare case of pediatric meningiomatosis in which MRI revealed multiple characteristic extra-axial enhancing lesions, subsequently confirmed by histopathological examination as World Health Organization grade I meningioma.