Intracranial Meningiomas In Patients Younger Than 35 Years Of Age: Evolution Of The Disease In The Era Of HIV Infection.

Abstract

Background: Intracranial meningiomas are most common among patients in their fifth to seventh decade of life and rare in children and young adults. They constitute 1.5% of all neoplasms in patients age <20 years, but ac- count for 13.5% of all neoplasms in patients age 20e34 years. They are often associated with hereditary or familial syndromes in children and young adults, and tend to be of high grade. Here we describe the histopathological sub- types of intracranial meningioma between human immunodeficiency virus 1 (HIV-1)-seropositive patients and the general population with intracranial meningiomas 35 years old and younger. Methods: Data were collected from all consecutive patients age ≤35 years diagnosed with intracranial meningioma between May 2003 and May 2015. Age was categorized as <20 years, 21e30 years, and >30 years. Histopathological grade was classified according to the 2000 World Health Organization (WHO) grading system as grade I, II, or III. Patients were grouped into an HIV-1e seropositive group and the general population, presumed seronegative. WHO grade II/III meningioma represented high-grade meningioma. Results: HIV-1e seropositive status was associated with increased risk of the development of high-grade (WHO grade II/III) meningioma (odds ratio, 2.9; 95% confidence interval, 1.06e8.09; P [ 0.04) compared with the general population of patients with meningiomas. No significant associations were found between WHO grade and age, sex, ethnicity/race, or location. Conclusions: Intracranial meningiomas in young HIV- 1epositive patients tend to be of high grade; therefore, conservative or non-invasive therapies should be offered with caution and only after tissue diagnosis has confirmed benign WHO grade.