Natural history of elderly patients with asymptomatic meningiomas
Masaki Niiroa, Kazutaka Yatsushiroa, Katsumi Nakamurab, Yoshihiro Kawaharaa, Jun-ichi Kuratsua
a Department of
Neurosurgery, Faculty of Medicine, University of Kagoshima, Kagoshima,
Japan 890-8520, b Division of Neurosurgery,
Gamma Knife Center of Fujimoto Hospital, Miyakonojyo, Japan 885-0055
Correspondence to: Dr Masaki Niiro, Department of Neurosurgery, Faculty of Medicine, University of Kagoshima, 8-35-1, Sakuragaoka, Kagoshima, 890-8520, Japan email niiromsk{at}med6.kufm.kagoshima-u.ac.jp
Received 5 January
1999 and in revised form 6 July 1999;
Accepted 2 August
1999
OBJECTIVE
For the
treatment of elderly patients with asymptomatic meningiomas, it is
important to determine their natural history. Based on results of
follow up examinations, the natural history of such patients was
clarified and prognostic factors concerning the potential of tumour
growth in the aged were identified.
METHODSThe clinical
records and imaging studies of 40 elderly (over 70 years) patients with
asymptomatic meningiomas were analysed. The patients were followed up
with repeated imaging studies, and changes in tumour size, clinical
signs, and outcomes were evaluated.
RESULTSThere were 32 women and eight men with a mean age of 76.1 years. The mean follow up
period was 38.4 months, ranging from 6 to 97 months. Six patients died
during the follow up period from disorders other than the tumours, and
one patient died as a result of the tumour. Twenty six patients (mean
follow up period 41.8 months, range 10-97 months) showed no tumour
growth. Fourteen patients showed tumour growth (mean follow up period
32.1 months, range 6-88 months). Five (four men and one woman) of
these patients became symptomatic. Based on imaging analysis (1)
calcification of the tumour was associated with no tumour growth
(p=0.036), and (2) the tumour size at the initial diagnosis was related
to subsequent tumour growth (p=0.016). Other possible factors related to tumour growth included sex and hyperintensity on MRI T2 weighted images.
CONCLUSIONIn elderly
patients with asymptomatic meningiomas, careful clinical follow up with
imaging studies is important. The imaging features mentioned may
contribute to prediction of tumour growth.
Keywords: aged; asymptomatic meningioma; natural history
© 2000 by Journal of Neurology, Neurosurgery, and Psychiatry
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