The Natural History and Growth Rate of Meningiomas

  • Han, Jung-Ho (Department of Neurosurgery, Seoul National University College of Medicine) ;
  • Seol, Ho-Jun (Department of Neurosurgery, Kangwon National University College of Medicine) ;
  • Kim, Dong-Gyu (Department of Neurosurgery, Seoul National University College of Medicine) ;
  • Jung, Hee-Won (Department of Neurosurgery, Seoul National University College of Medicine)
  • Published : 2006.03.30

Abstract

Objective : To evaluate the natural histories and growth rates of meningiomas, the authors perform this retrospective observational study and attempt to identify those factors predicting tumor growth. Methods : Between 1993 and 2004, a total of 83 patients were diagnosed by computed tomography[CT] scans or magnetic resonance[MR] imaging as having an intracranial meningioma, and were treated by observation only using regular clinical and radiological examinations. Twenty-six of these 83 patients, with available data were included in this study. Follow up periods ranged from 9 to 137 months [mean, 55.6 mo.; median, 60 mo.]. The tumor volumes, absolute growth rates, and tumor doubling times were calculated. Results : Patient age and sex distributions were comparable to those of other studies, but exceptionally 16 meningiomas [62%] were located at the skull base in the present study. During follow-up monitoring, the majority of meningiomas grew, though 77% showed low absolute annual growth rates [$<1cm^3/yr$]. The tumor doubling times ranged from 2.87 to 201.72 years [mean, 42.91 yr]. Based on Imaging analysis, peritumoral edema and the absence of calcification were probable factors predicting tumor growth. Tumor-related symptoms seemed to be slightly related to tumor growth. Other factors, e.g., gender, age, tumor location, and T2-weighted signal Intensities on MR imaging, were not significantly related to tumor growth. Conclusion : This study shows that the majority of meningiomas are slow growing. However, variations in tumor growth are unexplained, thus individualized optimal treatment strategies should be provided in each meningioma.

Keywords

References

  1. Arienta C, Caroli M, Balbi S : Intracranial meningiomas in patients over 70 years old. Follow-up in operated and unoperated cases. Aging Milano 4 : 29-33, 1992
  2. Awad IA, Kalfas I, Hahn JF, Little JR : Intracranial meningiomas in the aged : surgical outcome in the era of computed tomography. Neurosurgery 24 : 557- 560, 1989 https://doi.org/10.1227/00006123-198904000-00011
  3. Carpeggiani P, Crisi G, Trevisan C : MRI of intracranial meningiomas : correlations with histology and physical consistency. Neuroradiology 35 : 532-536, 1993 https://doi.org/10.1007/BF00588715
  4. Kim CY, Kim YY, Paek SH, Kim DG, Jung HW : Correlation of clinical and biological parameters with peritumoral edema in meningioma. J Korean Neurosurg Soc 31 : 461-468, 2002
  5. Chan RC, Thompson GB : Morbidity, mortality and quality of life following surgery for intracranial meningiomas. A retrospective study in 257 cases. J Neurosurg 60 : 52-60, 1984 https://doi.org/10.3171/jns.1984.60.1.0052
  6. Cornu P, Chatellier G, Dagreou F, Clemenceau S, Foncin JF, Rivierez M, et al : Intracranial meningiomas in elderly patients. Postoperative morbidity and mortality. Factors predictive of outcome. Acta Neurochir (Wien) 102 : 98- 102, 1990 https://doi.org/10.1007/BF01405421
  7. Firsching RP, Fischer A, Peters R, Thun F, Klug N : Growth rate of incidental meningiomas. J Neurosurg 73 : 545-547, 1990 https://doi.org/10.3171/jns.1990.73.4.0545
  8. Gijtenbeek JM, Hop WC, Braakman R, Avezaat CJ : Surgery for intracranial meningiomas in elderly patients. Clin Neurol Neurosurg 95 : 291-295, 1993 https://doi.org/10.1016/0303-8467(93)90104-O
  9. Jaaskelainen J, Haltia M, Laasonen E, Wahlstrom T, Valtonen S : The growth rate of intracranial meningiomas and its relation to histology. An analysis of 43 patients. Surg Neurol 24 : 165-172, 1985 https://doi.org/10.1016/0090-3019(85)90180-6
  10. Jung HW, Yoo H, Paek SH, Choi KS : Long-term outcome and growth rate of subtotally resected petroclival meningiomas : experience with 38 cases. Neurosurgery 46 : 567-575, 2000 https://doi.org/10.1097/00006123-200003000-00008
  11. Kakinuma K, Tanaka R, Onda K, Takahashi H : Proliferative potential of recurrent intracranial meningiomas as evaluated by labeling indices of BUdR and Ki-67, and tumour doubling time. Acta Neurochir (Wien) 140:26-32, 1998 https://doi.org/10.1007/s007010050053
  12. Kim JE, Kim DG, Chung HT, Paek SH, Jung HW : Gamma knife radiosurgery for skull base meningiomas. J Korean Neurosurg Soc 33 : 363-369, 2003
  13. Ligier Y, Ratib O, Logean M, Girard C : Osiris : a medical image-manipulation system. MD Comput 11 : 212-218, 1994
  14. Nakamura M, Roser F, Michel J, Jacobs C, Samii M : The natural history of incidental meningiomas. Neurosurgery 53 : 62-71, 2003 https://doi.org/10.1227/01.NEU.0000068730.76856.58
  15. Nakasu S, Nakajima M, Matsumura K, Nakasu Y, Handa J : Meningioma : proliferating potential and clinicoradiological features. Neurosurgery 37 : 1049-1055, 1995 https://doi.org/10.1227/00006123-199512000-00003
  16. Niiro M, Yatsushiro K, Nakamura K, Kawahara Y, Kuratsu J : Natural history of elderly patients with asymptomatic meningiomas. J Neurol Neurosurg Psychiatry 68 : 25-28, 2000 https://doi.org/10.1136/jnnp.68.1.25
  17. Olivero WC, Lister JR, Elwood PW : The natural history and growth rate of asymptomatic meningiomas : a review of 60 patients. J Neurosurg 83 : 222-224, 1995 https://doi.org/10.3171/jns.1995.83.2.0222
  18. Soyama N, Kuratsu J, Ushio Y : Correlation between magnetic resonance images and histology in meningiomas : T2-weighted images indicate collagen contents in tissues. Neurol Med Chir (Tokyo) 35 : 438-441, 1995 https://doi.org/10.2176/nmc.35.438
  19. Strugar JG, Criscuolo GR, Rothbart D, Harrington WN : Vascular endothelial growth/permeability factor expression in human glioma specimens : correlation with vasogenic brain edema and tumor-associated cysts. J Neurosurg 83 : 682-689, 1995 https://doi.org/10.3171/jns.1995.83.4.0682
  20. Van Havenbergh T, Carvalho G, Tatagiba M, Plets C, Samii M : Natural history of petroclival meningiomas. Neurosurgery 52 : 55-64, 2003 https://doi.org/10.1097/00006123-200301000-00006
  21. Yoneoka Y, Fujii Y, Tanaka R : Growth of incidental meningiomas. Acta Neurochir (Wien) 142 : 507-511, 2000 https://doi.org/10.1007/s007010050463