Acta Neurochirurgica

, Volume 157, Issue 2, pp 225–230 | Cite as

Long-term follow-up of incidentally discovered meningiomas

  • Kayvan D. Jadid
  • Maria Feychting
  • Jonas Höijer
  • Sofia Hylin
  • Lars Kihlström
  • Tiit Mathiesen
Clinical Article - Brain Tumors

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.

Keywords

Meningioma Incidental Natural history 

References

  1. 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):557–560CrossRefGoogle Scholar
  2. 2.
    Chamberlain MC, Barnholtz-Sloan JS (2011) Medical treatment of recurrent meningiomas. Expert Rev Neurother 11(10):1425–1432PubMedCrossRefGoogle Scholar
  3. 3.
    Chamoun R, Krisht KM, Couldwell WT (2011) Incidental meningiomas. Neurosurg Focus 31(6):E19PubMedCrossRefGoogle Scholar
  4. 4.
    Go SR, Taylor BV, Kimmel DW (1998) The natural history of asymptomatic meningiomas in Olmsted County, Minnesota. Neurol 51(6):1718–1720CrossRefGoogle Scholar
  5. 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):574–580PubMedCrossRefGoogle Scholar
  6. 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):375–383PubMedCrossRefGoogle Scholar
  7. 7.
    Nakamura M, Roser F, Michel J, Jacobs C, Samii M (2003) The natural history of incidental meningiomas. Neurosurg 53(1):62–70CrossRefGoogle Scholar
  8. 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):675–684CrossRefGoogle Scholar
  9. 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):314–321PubMedCrossRefGoogle Scholar
  10. 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):52–55PubMedCrossRefGoogle Scholar
  11. 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):222–224PubMedCrossRefGoogle Scholar
  12. 12.
    Yano S, Kuratsu J (2006) Indications for surgery in patients with asymptomatic meningiomas based on an extensive experience. J Neurosurg 105(4):538–543PubMedCrossRefGoogle Scholar
  13. 13.
    Kuratsu J, Kochi M, Ushio Y (2000) Incidence and clinical features of asymptomatic meningiomas. J Neurosurg 92(5):766–770PubMedCrossRefGoogle Scholar
  14. 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):25–28PubMedCentralPubMedCrossRefGoogle Scholar
  15. 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):555–562PubMedCrossRefGoogle Scholar
  16. 16.
    Mathiesen T, Lindquist C, Kihlström L, Karlsson B (1996) Recurrence of cranial base tumors. Neurosurg 39(1):2–7CrossRefGoogle Scholar
  17. 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):564–571CrossRefGoogle Scholar
  18. 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 693–710CrossRefGoogle Scholar
  19. 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):121–128PubMedCrossRefGoogle Scholar
  20. 20.
    Callaert H (2003) Comparing statistical software packages: the case of the logrank test in StatXact. Am Stat 57:214–217CrossRefGoogle Scholar
  21. 21.
    Yoneoka Y, Fujii Y, Tanaka R (2000) Growth of incidental meningiomas. Acta Neurochir 142(5):507–511PubMedCrossRefGoogle Scholar
  22. 22.
    Firsching PF, Fischer A, Peters R (1990) Growth rate of incidental meningiomas. J Neurosurg 73(4):545–547PubMedCrossRefGoogle Scholar
  23. 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):1036–1042Google Scholar
  24. 24.
    Accessed 15 Sept 2014Google Scholar
  25. 25.
    Sigurdsson AF (2014) Benefits of statins in healthy elderly subjects: what is the number needed to treat? J Am Coll Cardiol 63(21):2302PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Wien 2014

Authors and Affiliations

  • Kayvan D. Jadid
    • 1
    • 2
  • Maria Feychting
    • 3
  • Jonas Höijer
    • 4
  • Sofia Hylin
    • 5
  • Lars Kihlström
    • 1
    • 2
  • Tiit Mathiesen
    • 1
    • 2
  1. 1.Department of NeurosurgeryKarolinska University HospitalStockholmSweden
  2. 2.Department of clinical NeuroscienceKarolinska InstitutetStockholmSweden
  3. 3.Unit of EpidemiologyInstitute of Environmental Medicine, Karolinska InstitutetStockholmSweden
  4. 4.Unit of BiostatisticsInstitute of Environmental Medicine, Karolinska InstitutetStockholmSweden
  5. 5.Department of NeurologyKarolinska University HospitalStockholmSweden

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