Meningioma represents the most common intracranial tumor among adults. However, it is rara in pediatric patients. We are aimed to demonstrated the clinicopathological characteristics and long-term outcome of pediatric meningiomas (PMs).

We enrolled 74 patients with intracranial PMs. Clinicopathological characteristics and progression-free survival (PFS) were analyzed in PMs. PFS were compared between PMs and adult meningiomas (AMs). Univariate and multivariate Cox analysis was employed to evaluate the predictive values of clinicopathological characteristics.

40 females (54.1%) and 34 males (45.9%) patients were identified, resulting in a gender ratio of 1.18:1 in the PM cohort. Of the patients, 9 (12.2%) were diagnosed as neurofibromatosis type 2 (NF2) diseases, 65 (87.8%) were sporadic. The most common tumor location was the convexity (n=29, 39.2%), followed by skull base (n= 23, 31.1%), ventricular (n= 16, 21.6 %) and parasagittal (n= 6, 8.11%). 19 patients (25.7%) experienced recurrence during a median follow-up period of 33 months (range 2 -145.25 months). The 3-, 5-, and 8-year PFS rates was 74.74%, 74.74%, and 59.38%, respectively. When compared to AMs, no significant differences in PFS were observed between the two cohorts, even after propensity score matching (PSM). The multivariate Cox results showed NF2 disease (p<0.001) and EOR (p=0.013) were independently associated with the PFS of patients with PMs. A nomogram was constructed based on the results of the multivariate Cox analysis. The 3-, 5- and 8-year Area Under the Curve (AUC) of the nomogram was 0.927, 0.930, 0.870, respectively, indicating its superior predictive accuracy for long-term PFS.

PMs are characterized by their atypicality of male predominance, ventricular location, and NF2 disease. A nomogram with excellent predictive accuracy for long-term outcome was constructed.