Unique characteristics of pediatric sporadic vestibular schwannoma

Abstract

Objective: To investigate characteristics of pediatric sporadic (non-NF2) vestibular schwannoma (VS), we compare outcomes of sporadic adult-type vestibular schwannoma which were size- and location-matched cohort. Study design: Single-institution retrospective matched case-control study. Methods: Pediatric patients (<= 21 years) with sporadic unilateral VS and >= 15 months of follow-up were identified and each matched 1:2 to adult patients (>21 years) by tumor size and location. The primary outcome was tumor control (stable vs recurrence/regrowth requiring treatment). Outcomes within the pediatric cohort were further analyzed for age-related differences. Results: Nine pediatric patients were matched to 18 adult controls. Baseline characteristics and presenting symptoms were similar. Gross total resection was achieved in 44% of children and 22% of adults (P = 0.071). Tumor control differed significantly: recurrence/regrowth occurred in 44% of children versus 6% of adults (P = 0.005). Within the pediatric group, patients with recurrence were younger (13.8 +/- 2.8 vs 17.6 +/- 2.6 years; P = 0.043). Using a 14-year cutoff, three of four recurrences (75%) occurred in children <14 years versus none in older children (P = 0.048). Conclusions: Children, particularly those under 14 years, experienced significantly poorer tumor control after surgery for sporadic VS compared with adults, despite similar tumor size and location. The higher recurrence and regrowth rates observed in the pediatric cohort suggest that a more aggressive treatment and surveillance approach may be warranted.