Zusammenfassung
Hintergrund: Zu den zahlreichen Ursachen einer Lidschwellung zählen Tumoren verschiedener/n Dignität und Ursprungs. Meningeome als Ursache eines Orbitatumors ist vor allem im Kindes- und Jugendalter äußerst selten. Kasuistik: Bei einem 8-jährigen Mädchen wurde als Ursache einer einseitigen Oberlidschwellung ein frontobasal gelegenes Meningeom diagnostiziert. Anhand des Fallberichts werden die neuesten Erkenntnisse über Diagnostik, Behandlung und Nachsorge von Meningeomen im Kindes- und Jugendalter diskutiert. Schlussfolgerung: Die Behandlung von Meningeomen im Kindes- und Jugendalter erfordert eine enge interdisziplinäre Zusammenarbeit von Augenärzten, pädiatrischen Onkologen, Neurochirurgen und Strahlentherapeuten. Kontrollierte Untersuchungen sollten Aufschluss geben über die Effizienz moderner Bestrahlungstechniken oder Chemotherapien in der Behandlung von inoperablen oder malignen Meningeomen.
Abstract
Background: Tumours of the eyelid and orbit with different biological behaviour and localisation may cause eyelid swelling. Orbital meningiomas are rare, particularly in childhood and adolescence. Case Report: We report the case of an 8-year-old girl with frontobasal meningioma, who was admitted to the hospital because of a one-sided upper eyelid swelling. With the example of this case, the diagnosis, treatment and aftercare of meningiomas in childhood and adolescence will be discussed. Conclusions: The treatment strategy of meningiomas in childhood requires a close interdisciplinary cooperation of ophthalmology, paediatric oncology, neurosurgery and radiotherapy. Moreover, controlled investigations should yield information about the efficiency of modern irradiation techniques or adjuvant chemotherapy in the treatment of inoperable or malignant meningiomas.
Schlüsselwörter
Meningeome - intrakranielle Meningeome - Kinder - Jugendliche - Lidschwellung - Exophthalmus
Key words
Childhood meningiomas - adolescent meningiomas - intracranial meningiomas - eyelid swelling - exophthalmus
Literatur
1
Amirjamshidi A, Mehrazin M, Abbassioun K.
Meningiomas of the central nervous system occurring below the age of 17: Report of 24 cases not associated with neurofibromatosis and review of literature.
Childs Nerv Syst.
2000;
16
406-416
2
Castellano F, Guidetti B, Olivecrona H.
Pterional meningiomas en plaque.
J Neurosurg.
1952;
9
188-196
3
Collins V P, Nordenskjold M, Dumanski J P.
The molecular genetics of meningiomas.
Brain Pathol.
1990;
1
19-24
4
Di Rocco C, Di Rienzo A.
Meningiomas in childhood.
Critical Reviews in Neurosurgery.
1999;
9
180-188
5
Erdincler P, Lena G, Sarioglu A C. et al .
Intracranial meningiomas in children: Review of 29 cases.
Surg Neurol.
1998;
49
136-140; discussion 140 - 131
6
Feigl G C, Bundschuh O, Gharabaghi A. et al .
Volume reduction in meningiomas after gamma knife surgery.
J Neurosurg.
2005;
102 Suppl
189-194
7 Guthoff R, Hingst V, Schittkowski M. Tumoren der Orbita. Lommatzsch PK Ophthalmologische Onkologie Stuttgart; Enke 1999
8
Karnes P S, Tran T N, Cui M Y. et al .
Cytogenetic analysis of 39 pediatric central nervous system tumors.
Cancer Genet Cytogenet.
1992;
59
12-19
9
Ketter R, Henn W, Feiden W. et al .
Nasoethmoidal meningioma with cytogenetic features of tumor aggressiveness in a 16-year-old child.
Pediatr Neurosurg.
2003;
39
190-194
10
Ketter R, Henn W, Niedermayer I. et al .
Predictive value of progression-associated chromosomal aberrations for the prognosis of meningiomas: A retrospective study of 198 cases.
J Neurosurg.
2001;
95
601-607
11
Kleihues P, Sobin L H.
World health organization classification of tumors.
Cancer.
2000;
88
2887
12
Kyritsis A P.
Chemotherapy for meningiomas.
J Neurooncol.
1996;
29
269-272
13
Lieb W E.
Tumors of the orbits.
Ophthalmologe.
1994;
91
701-716
14
Mallucci C L, Parkes S E, Barber P. et al .
Paediatric meningeal tumours.
Childs Nerv Syst.
1996;
12
582-588; discussion 589
15
Milker-Zabel S, Zabel A, Schulz-Ertner D. et al .
Fractionated stereotactic radiotherapy in patients with benign or atypical intracranial meningioma: Long-term experience and prognostic factors.
Int J Radiat Oncol Biol Phys.
2005;
61
809-816
16
Mirimanoff R O, Dosoretz D E, Linggood R M. et al .
Meningioma: Analysis of recurrence and progression following neurosurgical resection.
J Neurosurg.
1985;
62
18-24
17
Muller P, Henn W, Niedermayer I. et al .
Deletion of chromosome 1p and loss of expression of alkaline phosphatase indicate progression of meningiomas.
Clin Cancer Res.
1999;
5
3569-3577
18 Naumann G O, Apple D J, Deuble-Bente K. et al .Pathologie des Auges. Heidelberg/Berlin/New York; Springer Verlag 1997
19
Ng H K, Lau K M, Tse J Y. et al .
Combined molecular genetic studies of chromosome 22q and the neurofibromatosis type 2 gene in central nervous system tumors.
Neurosurgery.
1995;
37
764-773
20
Niedermayer I, Feiden W, Henn W. et al .
Loss of alkaline phosphatase activity in meningiomas: A rapid histochemical technique indicating progression-associated deletion of a putative tumor suppressor gene on the distal part of the short arm of chromosome 1.
J Neuropathol Exp Neurol.
1997;
56
879-886
21
Ohtsuka K, Hashimoto M, Suzuki Y.
A review of 244 orbital tumors in japanese patients during a 21-year period: Origins and locations.
Jpn J Ophthalmol.
2005;
49
49-55
22
Preston-Martin S.
Descriptive epidemiology of primary tumors of the brain, cranial nerves and cranial meninges in los angeles county.
Neuroepidemiology.
1989;
8
283-295
23
Rausing A, Ybo W, Stenflo J.
Intracranial meningioma - a population study of ten years.
Acta Neurol Scand.
1970;
46
102-110
24
Rochat P, Johannesen H H, Gjerris F.
Long-term follow up of children with meningiomas in Denmark: 1935 to 1984.
J Neurosurg.
2004;
100
179-182
25 Rohrbach J M, Lieb W E. Tumoren des Auges und seiner Adnexe. Stuttgart; Schattauer 1998
26 Rootmann J. Disease of the orbit. Lippincott; Williams & Wilkins 2003
27
Ruttledge M H, Sarrazin J, Rangaratnam S. et al .
Evidence for the complete inactivation of the nf2 gene in the majority of sporadic meningiomas.
Nat Genet.
1994;
6
180-184
28
Sandberg D I, Edgar M A, Resch L. et al .
Mib-1 staining index of pediatric meningiomas.
Neurosurgery.
2001;
48
590-595; discussion 595 - 597
29
Sano K, Wakai S, Ochiai C. et al .
Characteristics of intracranial meningiomas in childhood.
Childs Brain.
1981;
8
98-106
30
Shields J A, Shields C L, Scartozzi R.
Survey of 1264 patients with orbital tumors and simulating lesions: The 2002 montgomery lecture, part 1.
Ophthalmology.
2004;
111
997-1008
31
Schrell U M, Rittig M G, Anders M. et al .
Hydroxyurea for treatment of unresectable and recurrent meningiomas. II. Decrease in the size of meningiomas in patients treated with hydroxyurea.
J Neurosurg.
1997;
86
840-844
32
Suh J H, Barnett G H.
Stereotactic radiosurgery for brain tumors in pediatric patients.
Technol Cancer Res Treat.
2003;
2
141-146
33
Taylor B W Jr, Marcus R B Jr, Friedman W A. et al .
The meningioma controversy: Postoperative radiation therapy.
Int J Radiat Oncol Biol Phys.
1988;
15
299-304
34
Tufan K, Dogulu F, Kurt G. et al .
Intracranial meningiomas of childhood and adolescence.
Pediatr Neurosurg.
2005;
41
1-7
35
Turgut M, Ozcan O E, Bertan V.
Meningiomas in childhood and adolescence: A report of 13 cases and review of the literature.
Br J Neurosurg.
1997;
11
501-507
36
Wallace M R, Marchuk D A, Andersen L B. et al .
Type 1 neurofibromatosis gene: Identification of a large transcript disrupted in three nf1 patients.
Science.
1990;
249
181-186
37
Wowra B, Horstmann G A, Cibis R. et al .
Profile of ambulatory radiosurgery with the gamma knife system. 2. Report of clinical experiences.
Radiologe.
1997;
37
1003-1015
38
Yoon H K, Kim S S, Kim I O. et al .
Mri of primary meningeal tumours in children.
Neuroradiology.
1999;
41
512-516
39
Zang K D.
Cytological and cytogenetical studies on human meningioma.
Cancer Genet Cytogenet.
1982;
6
249-274
40
Zwerdling T, Dothage J.
Meningiomas in children and adolescents.
J Pediatr Hematol Oncol.
2002;
24
199-204
Dr. Jürgen Föll
Hämatologie, Onkologie, Immunologie, Universitätsklinik und Poliklinik für Kinder- und Jugendmedizin
Ernst-Grube Str. 40
06120 Halle/Saale
Telefon: 03 45/5 57-20 36/32 57
Fax: 03 45/5 57 72 55
eMail: juergen.foell@medizin.uni-halle.de