Meningeoma de terceiro ventrículo em criança / Third ventricle meningioma in a child

Meningeomas localizados nos ventrículos são bastante raros, ocorrendo em torno de 1,5% a 2% dos casos, e no terceiro ventrículo localizam-se apenas 15% desses. O processo torna-se mais raro quanto menor a idade. Apresentamos um caso de meningeoma de terceiro ventrículo, com expansão para os ventrículos laterais, principalmente o direito, em uma criança de 11 anos. Segundo a família, aos 9 anos apresentou cefaléia e, na época, atendida por neurologista, foi medicada com fenitoína, tendodesaparecido o quadro. Três meses antes de procurar o nosso Serviço, começou novamente a ter cefaléia di fusa, de caráter progressivo. Foi submet ida a exames que most raram processo expansivo no terceiro ventrículo, com expansão para ventrículos laterais, bastante vascularizado, bem delimitado e originando-se ao nível do plexo coróide. Foi submetida à cirurgia e o diagnóstico histopatológico foi de meningeoma psamomatoso.

Meningiomas located in the cerebral ventricles are quite rare, being reported in 1.5% to 2% of all cases, and only 15% of these are located in the third ventricle. The process becomes rarer as the age decreases.We present a case of meningioma of the third ventricle, with expansion into the lateral ventricles, mainly to the right, in a 11 year-old girl. According to her family, two years before admission in our Service she presented headache; phenytoin prescribed elsewhere had alleviated the complaint.Three months before she started again to have diffuse and progressive headaches. She was submitted to CT and MRI that showed a well delimited tumor in the third ventricle with expansion into the lateral ventricles.She was submitted to surgery and the histopathology confirmed the diagnosis of psamomatosus meningioma.

Primary Third Ventricular Tumors

Intrathird ventricular tumors that mainly occupy the ventricle cavity without extending to the neighbouring structures are rare. These tumors are developed from the choroids plexus, tela, ependyma, subjacent neuroglia and embryonic cell rest. The authors experienced 11 cases of rare intrathird ventricular tumors during the past 10 years. During the same period, number of surgically proven brain tumors were 990 and intrathird ventricular tumors comprised 1.1%. These are two cases of choroids plexus papillomas, three craniopharyngiomas, two germ cell tumors, one meningioma, one glioependymal cyst, one ependymoma, one astrocytoma. Suprasellar craniopharyngiomas, thalamic gliomas, optic and hypothalamic gliomas were excluded. The age distribution was from 6 years old to 59 years old. The clinical manifestation was characteristic in that they usually had the sudden intermittent headache without specific localizing signs. Surgical approach to this area is by transcallosal or transcortical approach. Surgical total removal was quite feasible by either approach and outcome was rather favorable.

Primary Third Ventricular Tumors

Intrathird ventricular tumors that mainly occupy the ventricle cavity without extending to the neighbouring structures are rare. These tumors are developed from the choroids plexus, tela, ependyma, subjacent neuroglia and embryonic cell rest. The authors experienced 11 cases of rare intrathird ventricular tumors during the past 10 years. During the same period, number of surgically proven brain tumors were 990 and intrathird ventricular tumors comprised 1.1%. These are two cases of choroids plexus papillomas, three craniopharyngiomas, two germ cell tumors, one meningioma, one glioependymal cyst, one ependymoma, one astrocytoma. Suprasellar craniopharyngiomas, thalamic gliomas, optic and hypothalamic gliomas were excluded. The age distribution was from 6 years old to 59 years old. The clinical manifestation was characteristic in that they usually had the sudden intermittent headache without specific localizing signs. Surgical approach to this area is by transcallosal or transcortical approach. Surgical total removal was quite feasible by either approach and outcome was rather favorable.