Skip to main content
Log in

Long-term follow-up of incidentally discovered meningiomas

  • Clinical Article - Brain Tumors
  • Published:
Acta Neurochirurgica Aims and scope Submit manuscript

Abstract

Background

Many incidental meningiomas are detected and need to be assessed for further management. Better knowledge of the long-term natural history is necessary for optimal management.

Methods

We have retrospectively evaluated a cohort of consecutive patients who were referred to the authors at the Department of Neurosurgery with incidentally diagnosed asymptomatic meningiomas from 1991–1998 and followed prospectively. All patients were followed for a minimum of 10 years or until they reached the endpoint of demonstrated tumour growth or died.

Results

During follow-up, 35.4 % of the tumours grew, resulting in a 75 % 15-year growth rate by life-table statistics. The growth rates were similar in smaller (<2 cm) and larger tumours, while calcified tumours grew at a lower rate. The latter difference was, however, not statistically significant.

Conclusion

Long-term tumour growth of incidentally detected asymptomatic meningiomas appeared to be much higher than expected. This information needs to be considered when discussing surgery, since the indication for surgery may be stronger than previously stated, especially for younger patients with tumours that can be reached at low risk.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Awad IA, Kalfas I, Hahn JF, Little JR (1989) Intracranial meningiomas in the aged: surgical outcome in the era of computed tomography. Neurosurg 24(4):557–560

    Article  CAS  Google Scholar 

  2. Chamberlain MC, Barnholtz-Sloan JS (2011) Medical treatment of recurrent meningiomas. Expert Rev Neurother 11(10):1425–1432

    Article  CAS  PubMed  Google Scholar 

  3. Chamoun R, Krisht KM, Couldwell WT (2011) Incidental meningiomas. Neurosurg Focus 31(6):E19

    Article  PubMed  Google Scholar 

  4. Go SR, Taylor BV, Kimmel DW (1998) The natural history of asymptomatic meningiomas in Olmsted County, Minnesota. Neurol 51(6):1718–1720

    Article  CAS  Google Scholar 

  5. Hashimoto N, Rabo CS, Okita Y, Kinoshita M, Kagawa N, Fujimoto Y, Morii E, Kishima H, Maruno M, Kato A, Yoshimine T (2012) Slower growth of skull base meningiomas compared with non–skull base meningiomas based on volumetric and biological studies. J Neurosurg 116(3):574–580

    Article  PubMed  Google Scholar 

  6. Mantle RE, Lach B, Delgado MR, Baeesa S, Bélanger G (1999) Predicting the probability of meningioma recurrence based on the quantity of peritumoral brain edema on computerized tomography scanning. J Neurosurg 91(3):375–383

    Article  CAS  PubMed  Google Scholar 

  7. Nakamura M, Roser F, Michel J, Jacobs C, Samii M (2003) The natural history of incidental meningiomas. Neurosurg 53(1):62–70

    Article  Google Scholar 

  8. Hashiba T, Hashimoto N, Izumoto S, Suzuki T, Kagawa N, Maruno M, Kato A, Yoshimine T (2009) Serial volumetric assessment of the natural history and growth pattern of incidentally discovered meningiomas. J Neurosurg 100(4):675–684

    Article  Google Scholar 

  9. Nakamura H, Makino K, Yano S, Kuratsu J (2011) Epidemiological study of primary intracranial tumors: a regional survey in Kumamoto prefecture in southern Japan—20-year study. Int J Clin Oncol 16(4):314–321

    Article  PubMed  Google Scholar 

  10. Nishizaki T, Ozaki S, Kwak T, Ito H (1999) Clinical features and surgical outcome in patients with asymptomatic meningiomas. Br J Neurosurg 13(1):52–55

    Article  CAS  PubMed  Google Scholar 

  11. Olivero WC, Lister JR, Elwood PW (1995) The natural history and growth rate of asymptomatic meningiomas: a review of 60 patients. J Neurosurg 83(2):222–224

    Article  CAS  PubMed  Google Scholar 

  12. Yano S, Kuratsu J (2006) Indications for surgery in patients with asymptomatic meningiomas based on an extensive experience. J Neurosurg 105(4):538–543

    Article  PubMed  Google Scholar 

  13. Kuratsu J, Kochi M, Ushio Y (2000) Incidence and clinical features of asymptomatic meningiomas. J Neurosurg 92(5):766–770

    Article  CAS  PubMed  Google Scholar 

  14. Niiro M, Yatsushiro K, Nakamura K, Kawahara Y, Kuratsu J (2000) Natural history of elderly patients with asymptomatic meningiomas. J Neurol Neurosurg Psychiatr 68(1):25–28

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  15. Black PM, Villavicencio AT, Rhouddou C, Loeffler JS (2001) Aggressive surgery and focal radiation in the management of meningiomas of the skull base: preservation of function with maintenance of local control. Acta Neurochir 143(6):555–562

    Article  CAS  PubMed  Google Scholar 

  16. Mathiesen T, Lindquist C, Kihlström L, Karlsson B (1996) Recurrence of cranial base tumors. Neurosurg 39(1):2–7

    Article  CAS  Google Scholar 

  17. Pettersson-Segerlind J, Orrego A, Lönn S, Mathiesen T (2011) Long-term 25-year follow-up of surgically treated parasagittal meningiomas. J World Neurosurg 76(6):564–571

    Article  Google Scholar 

  18. Mathiesen T (2010) Recurrence of Meningiomas and its management. In: Pamir N, Black P, Fahlbusch R (eds) Meningiomas: A comprehensiv text. Saunders, Philadelphia, pp 693–710

    Chapter  Google Scholar 

  19. Oya S, Kawai K, Nakatomi H, Saito N (2012) Significance of Simpson grading system in modern meningioma surgery: integration of the grade with MIB-1 labeling index as a key to predict the recurrence of WHO Grade I meningiomas. J Neurosurg 117(1):121–128

    Article  PubMed  Google Scholar 

  20. Callaert H (2003) Comparing statistical software packages: the case of the logrank test in StatXact. Am Stat 57:214–217

    Article  Google Scholar 

  21. Yoneoka Y, Fujii Y, Tanaka R (2000) Growth of incidental meningiomas. Acta Neurochir 142(5):507–511

    Article  CAS  PubMed  Google Scholar 

  22. Firsching PF, Fischer A, Peters R (1990) Growth rate of incidental meningiomas. J Neurosurg 73(4):545–547

    Article  CAS  PubMed  Google Scholar 

  23. Sughrue ME, Rutkowski MJ, Aranda D, Barani IJ, McDermott MW, Pars AT (2010) Treatment decision making based on the published natural history and growth rate of small meningiomas. J Neurosurg 143(5):1036–1042

  24. Accessed 15 Sept 2014

  25. Sigurdsson AF (2014) Benefits of statins in healthy elderly subjects: what is the number needed to treat? J Am Coll Cardiol 63(21):2302

    Article  PubMed  Google Scholar 

Download references

Conflict of interest

All authors certify that they have no affiliations with or involvement in any organisation or entity with any financial interest (such as honoraria; educational grants; participation in speakers’ bureaus; membership, employment, consultancies, stock ownership or other equity interest; and expert testimony or patent-licensing arrangements) or non-financial interest (such as personal or professional relationships, affiliations, knowledge or beliefs) in the subject matter or materials discussed in this manuscript.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Tiit Mathiesen.

Additional information

Comment

Meningiomas are tumours and tumours grow. Luckily, small incidental ones do not in general grow very much. However, this very long-term observational study shows that if you wait long enough, a proportion may grow a little and sometimes cause problems. The trick is to have some system for making the decision when to intervene. Calcification may give us some information; otherwise it is down to careful review. The study reminds us that the surgeon does not need to offer surgery every time.

Michael Powell

London, UK

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Jadid, K.D., Feychting, M., Höijer, J. et al. Long-term follow-up of incidentally discovered meningiomas. Acta Neurochir 157, 225–230 (2015). https://doi.org/10.1007/s00701-014-2306-3

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00701-014-2306-3

Keywords

Navigation