A Multimodal Approach to the Treatment of Intraparenchymal Meningioma in a 7-Year-Old Boy: A Case Report.

Intraparenchymal meningiomas are very rare: only 26 cases have been diagnosed in patients younger than 20 years since 1954. They can lead to preoperative differential diagnosis mistakes due to their atypical neuroimaging appearance. A multimodal approach is thus necessary to plan a surgical procedure aiming to receive the best extent of resection while preserving the patient's functional integrity. The authors report the case of a 7-year-old boy with a history of blurred vision, left eye deviation, and weakness on the left side of his body. Magnetic resonance imaging (MRI) revealed an intra-axial, cortical, right parietal lesion without dural attachment. MR spectroscopy and perfusion study were obtained. Since the patient was 100% left-handed, functional MRI, diffusion tensor imaging, and neuropsychological evaluation were performed before the surgical procedure. Histopathological analysis revealed the mass to be an atypical meningioma (WHO grade II). Postoperative MRI indicated complete macroscopic lesion removal. The postsurgical neuropsychological profile was not different from the profile before surgery. The boy was discharged 3 days after the surgical operation without any neurological deficits.