9.12.8.6Prognosis

•Depends on tumor type; i.e., diffuse infiltrating tumors have a poor prognosis

•Radical excision or radiotherapy alone: 50–90% long-term survival

•Subtotal tumor excision with radiotherapy: 60–85% long-term survival

9.12.9 Meningioma

9.12.9.1Incidence and Pathology

• Rare tumor in childhood

• Also occurrence as second tumor, especially in survivors of ALL who received cranial irradiation

• Ratio of males to females is 1:1

• Arise in dural, arachnoidal, or leptomeningeal areas

• Tumor mostly with thin capsule; invasive growth common

• Dense tumor with calcification characteristic

• Various histological subtypes exist but without obvious clinical importance, except for the angioplastic subtype that is associated with rapid growth, infiltration, sarcomatous degeneration, a high rate of metastatic spread, and relapse

• Increased incidence in survivors of ALL who received cranial irradiation

9.12.9.2Location

•Various locations: intracranial, spinal (mainly thoracic or cervical, seldom lumbar)

9.12.9.3 Clinical Manifestation

•Intracranial pressure

•Seizures

•Hemianopia

•Hemiparesis

9.12.9.4Therapy

• Usually surgical resection is possible

9.12.10Intramedullary Spinal Cord Tumors

9.12.10.1 Incidence

• Three to five percent of CNS tumors, including children with neurofibromatosis

• Mean age of 10 years

9.12.10.2 Pathology

• Astrocytoma 70%

• Ependymoma 10%

• Oligodendroglioma or ganglioglioma 10%

• High-grade glioma 10%