Natural history of spheno-orbital meningiomas.
BACKGROUND
To investigate the natural history and the growth rate of spheno-orbital meningiomas (SOMs).


METHODS
Ninety patients with a diagnosis of SOM were included, and patient charts and imaging were evaluated. In a subset of 32 patients, volumetric studies were performed.


RESULTS
The median follow-up for the entire group was 4 years (range, 1-15); the mean age was 47.8 (range, 26-93) years; 94% of the patients were female. The most common clinical signs and symptoms were proptosis (93%), visual deterioration (65%), retro-bulbar pain (23%) and diplopia (6%). In 35% of patients in this series, no visual deterioration occurred, and in 30% only mild proptosis was present. The median annual growth rate of the SOMs in the subset of 32 patients was 0.3 cm³/year (range, 0.03-1.8 cm³/year). We assessed a trend for more rapid tumour growth in younger patients and found the initial volume of the tumour (rho = 0.63) and of the soft tissue component (rho = 074) to be significantly related to the growth rate.


CONCLUSIONS
SOMs are slow-growing tumours that cause primarily proptosis and visual deterioration. In a significant number of patients, these tumours cause minimal discomfort and symptomatology. Therefore, in the absence of risk factors, we advocate a "wait and see" policy. For patients with large SOMs or with a large soft tissue component at first visit or with fast growing SOMs (>1cm³/year), a follow-up examination every 6 months is indicated.
Academic Medical Centre, University of Amsterdam, The Netherlands. p.saeed@amc.uva.nl
Peerooz
P
Saeed
Wouter R
WR
van Furth
Michael
M
Tanck
Fabio
F
Kooremans
Nicole
N
Freling
Geert I
GI
Streekstra
Noortje I
NI
Regensburg
Jan Willem Berkelbach
JW
van der Sprenkel
Saskia M
SM
Peerdeman
Jakobus J
JJ
van Overbeeke
Maarten P
MP
Mourits
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008577:Meningeal Neoplasms / Q000150:complications / Q000175:diagnosis / Q000473:pathology*; D008579:Meningioma / Q000150:complications / Q000175:diagnosis / Q000473:pathology*; D008875:Middle Aged; D009918:Orbital Neoplasms / Q000150:complications / Q000175:diagnosis / Q000473:pathology*; D019292:Skull Base Neoplasms / Q000150:complications / Q000175:diagnosis / Q000473:pathology