title: The Natural History of Petroclival Meningiomas: A Volumetric Study.
abstract: This study characterizes primary petroclival meningioma growth rates, before intervention, using volumetric analysis. In addition, predictors of growth are analyzed.
  
  
  
  Patients with previously untreated petroclival meningiomas were retrospectively reviewed (1999-2015). Image analysis software was used to perform volumetric analyses of tumor size and growth. Three-dimensional segmentation volumetric analyses were compared with volumes estimated utilizing three orthogonal dimensions. Tumor growth was defined as a 15% increase in volume.
  
  
  
  Thirty-four patients who underwent at least two magnetic resonance imaging (MRI) studies before intervention were included. The mean age was 55.2 years, and 65.7% were women. The mean tumor volume at presentation was 5.6 cm (range, 0.1-25.8 cm) as determined from segmentation volumetric analysis. At a mean follow-up of 44.5 months (range, 3.7-125.1 mo), 88.2% of tumors grew. The mean annual volumetric growth rate was 2.38 cm/yr (-0.63 to 25.9 cm/yr). Tumor volume, T2 hyperintensity within the tumor, peritumoral edema, and ataxia and/or cerebellar symptoms at presentation were all significantly associated with greater rates of tumor growth. Ultimately, 10 (29.4%) patients underwent treatment during the follow-up period.
  
  
  
  Our experience demonstrates that the vast majority (88%) of untreated petroclival meningiomas grow; the mean volumetric growth rate was noted to be 2.38 cm/yr. We found a significant association between increased growth rate and larger tumor size at diagnosis, T2 hyperintensity within the tumor, peritumoral edema, and the presence of ataxia and/or cerebellar symptoms.
authors.affiliation: *Department of Otolaryngology-Head and Neck Surgery †Department of Neurological Surgery, Vanderbilt University Medical Center, Nashville, Tennessee ‡Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic School of Medicine, Rochester, Minnesota.
authors.forename: Jacob B
authors.initials: JB
authors.lastname: Hunter
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Yawn
authors.forename: Ray
authors.initials: R
authors.lastname: Wang
authors.forename: Brendan P
authors.initials: BP
authors.lastname: O'Connell
authors.forename: Matthew L
authors.initials: ML
authors.lastname: Carlson
authors.forename: Akshitkumar
authors.initials: A
authors.lastname: Mistry
authors.forename: David S
authors.initials: DS
authors.lastname: Haynes
authors.forename: Reid C
authors.initials: RC
authors.lastname: Thompson
authors.forename: Kyle D
authors.initials: KD
authors.lastname: Weaver
authors.forename: George B
authors.initials: GB
authors.lastname: Wanna
mesh_terms: D000328:Adult; D000368:Aged; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008579:Meningioma / Q000473:pathology*; D008875:Middle Aged; D012189:Retrospective Studies; D019292:Skull Base Neoplasms / Q000473:pathology*; D047368:Tumor Burden