Meningioma natural history: Difference between revisions
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* Linear growth may be seen in 44% of patients, while volumetric growth may be seen in 74%.<ref name="pmid21250802">{{cite journal| author=Oya S, Kim SH, Sade B, Lee JH| title=The natural history of intracranial meningiomas. | journal=J Neurosurg | year= 2011 | volume= 114 | issue= 5 | pages= 1250-6 | pmid=21250802 | doi=10.3171/2010.12.JNS101623 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21250802 }} </ref> | * Linear growth may be seen in 44% of patients, while volumetric growth may be seen in 74%.<ref name="pmid21250802">{{cite journal| author=Oya S, Kim SH, Sade B, Lee JH| title=The natural history of intracranial meningiomas. | journal=J Neurosurg | year= 2011 | volume= 114 | issue= 5 | pages= 1250-6 | pmid=21250802 | doi=10.3171/2010.12.JNS101623 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21250802 }} </ref> | ||
* A higher annual growth rate may be seen in patients with an initial tumor diameter of greater than 25mm, MR imaging T2 signal hyperintensity, patients presenting with symptoms and edema, and male patients.<ref name="pmid21250802">{{cite journal| author=Oya S, Kim SH, Sade B, Lee JH| title=The natural history of intracranial meningiomas. | journal=J Neurosurg | year= 2011 | volume= 114 | issue= 5 | pages= 1250-6 | pmid=21250802 | doi=10.3171/2010.12.JNS101623 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21250802 }} </ref> | * A higher annual growth rate may be seen in patients with an initial tumor diameter of greater than 25mm, MR imaging T2 signal hyperintensity, patients presenting with symptoms and edema, and male patients.<ref name="pmid21250802">{{cite journal| author=Oya S, Kim SH, Sade B, Lee JH| title=The natural history of intracranial meningiomas. | journal=J Neurosurg | year= 2011 | volume= 114 | issue= 5 | pages= 1250-6 | pmid=21250802 | doi=10.3171/2010.12.JNS101623 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21250802 }} </ref> | ||
* | * Meningomas are usually single but can be multiple in about 1-10% of patients. Multiple meningiomas are usually seen in patients with neurofibromatosis.<ref name="pmid23776757">{{cite journal| author=Wong RH, Wong AK, Vick N, Farhat HI| title=Natural history of multiple meningiomas. | journal=Surg Neurol Int | year= 2013 | volume= 4 | issue= | pages= 71 | pmid=23776757 | doi=10.4103/2152-7806.112617 | pmc=3683641 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23776757 }} </ref><ref name="pmid6864264">{{cite journal| author=Sheehy JP, Crockard HA| title=Multiple meningiomas: a long-term review. | journal=J Neurosurg | year= 1983 | volume= 59 | issue= 1 | pages= 1-5 | pmid=6864264 | doi=10.3171/jns.1983.59.1.0001 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=6864264 }} </ref> | ||
* The rate of growth in patients with multiple meningiomas is similar to those with solitary meningiomas. | * The rate of growth in patients with multiple meningiomas is similar to those with solitary meningiomas. | ||
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Haytham Allaham, M.D. [2]
Overview
If left untreated, patients with meningioma may progress to develop morning headache, focal neurological deficit, and altered mental status. Common complications of meningioma include increased intracranial pressure, cranial nerve palsies, and hydrocephalus. Prognosis is generally good, and the survival rate of patients with meningioma mainly depends on the grade and location of the tumor.[1][2]
Natural History
- The median age at diagnosis of meningioma is about 65 years, with incidence increasing with advancing age.[3]
- Most patients with meningioma are asymptomatic. If left untreated, patients with meningioma may progress to develop morning headache, focal neurological deficit, and altered mental status.[1]
- Absence of calcification, age 60 or younger, and initial tumor diameter of greater than 25mm are among the factors associated with a short time to progression.[4]
- Linear growth may be seen in 44% of patients, while volumetric growth may be seen in 74%.[4]
- A higher annual growth rate may be seen in patients with an initial tumor diameter of greater than 25mm, MR imaging T2 signal hyperintensity, patients presenting with symptoms and edema, and male patients.[4]
- Meningomas are usually single but can be multiple in about 1-10% of patients. Multiple meningiomas are usually seen in patients with neurofibromatosis.[5][6]
- The rate of growth in patients with multiple meningiomas is similar to those with solitary meningiomas.
Complications
- Common complications of meningioma include:[1]
Prognosis
- The 5 year estimated survival for benign tumors is 85.6%, 82.3% for borderline malignant tumors, and 66% for malignant tumors. A poorer survival rate may be seen in patients of advanced age, male patients, black race, malignant tumors, and patients with no initial treatment.[3]
- Depending on the histological grade of the meningioma at the time of diagnosis, the prognosis may vary. However, the prognosis is generally regarded as good.[1]
- Grade 1 meningioma is associated with a median survival of approximately 10 years.[2]
- Grade 3 meningioma is associated with a median survival of approximately 2.7 years.
- The table below lists common prognostic factors for meningioma:[7]
| Prognostic Factor | Description |
| Age | Older age is associated with a worse prognosis |
| Anatomical location | Meningioma located at the base of the skull is associated with a poor prognosis due to difficult surgical resection. |
| Labeling index using MIB-1 test | A greater MIB-1 labeling index is associated with a worse prognosis. |
| Histological grade | A grade 3 anaplastic meningioma is associated with the worst prognosis. |
| Functional neurological status | Low score on the Karnofsky Performance Scale is associated with a worse prognosis. |
| Sex hormone receptor | Meningiomas that lack progesterone receptors are associated with a worse prognosis due to a higher recurrence rate following surgery.[2] |
References
- ↑ 1.0 1.1 1.2 1.3 Meningioma. Wikipedia(2015) https://en.wikipedia.org/wiki/Meningioma#cite_ref-17 Accessed on September, 25 2015
- ↑ 2.0 2.1 2.2 Fathi AR, Roelcke U (2013). "Meningioma". Curr Neurol Neurosci Rep. 13 (4): 337. doi:10.1007/s11910-013-0337-4. PMID 23463172.
- ↑ 3.0 3.1 Dolecek TA, Dressler EV, Thakkar JP, Liu M, Al-Qaisi A, Villano JL (2015). "Epidemiology of meningiomas post-Public Law 107-206: The Benign Brain Tumor Cancer Registries Amendment Act". Cancer. 121 (14): 2400–10. doi:10.1002/cncr.29379. PMC 5549267. PMID 25872752.
- ↑ 4.0 4.1 4.2 Oya S, Kim SH, Sade B, Lee JH (2011). "The natural history of intracranial meningiomas". J Neurosurg. 114 (5): 1250–6. doi:10.3171/2010.12.JNS101623. PMID 21250802.
- ↑ Wong RH, Wong AK, Vick N, Farhat HI (2013). "Natural history of multiple meningiomas". Surg Neurol Int. 4: 71. doi:10.4103/2152-7806.112617. PMC 3683641. PMID 23776757.
- ↑ Sheehy JP, Crockard HA (1983). "Multiple meningiomas: a long-term review". J Neurosurg. 59 (1): 1–5. doi:10.3171/jns.1983.59.1.0001. PMID 6864264.
- ↑ Meningioma: Stages and Grades Cancer.net(2015) http://www.cancer.net/cancer-types/meningioma/stages-and-grades Accessed on September, 25 2015