Introduction.The increased use of magnetic resonan-ce and computed tomography imaging has facilitatedthe diagnosis of brain tumours even before the patientsshow clinical symptoms and signs. A significant amountof incidental lesions identified are meningiomas. Thenatural history of incidental intracranial meningiomas mustbe known in order to develop the optimal therapeuticstrategy: what is the tumor growth rate? How many asymp-tomatic tumours eventually become symptomatic?Object. The aim of this study was to report our expe-rience of incidental asymptomatic intracranial menin-giomas and the different adopted treatment modali-ties, such as conservative treatment, microsurgery (MS)and Cyber-Knife radiosurgery.Materials and Methods. We searched retrospectivelyall patients with intracranial meningiomas treated inour Department in the last 8 years. Between January2004 and May 2012, 188 patients with intracranial me-ningiomas were examined. Among those patients, 24cases (12,8%) presented an incidental meningioma. Thisgroup was made up of 17 females (71%) and 7 males(29%), with a mean age of 67 years. The incidentalfinding was consequent to head trauma in 16 cases,endocrinal disorders in 3 cases, acute cerebrovasculardisease in 3 cases, typical trigeminal neuralgia with aneurovascular conflict in 1 case, and senile dementia in1 patient. Treatment modalities were essentially micro-surgical removal of the tumour, Cyber-Knife radiosur-gery and clinical observation.Results and conclusions. In our series, 12 patientsunderwent surgical treatment (6 females and 6 males,mean age of 65 years), 3 patients were treated withCyber-knife radiosurgery (all females, mean age of 66years), while 9 patients (8 females and 1 male, mean ageof 70 years) were clinically monitored. Surgical treatedpatients did not have any permanent neurologic defici-ts and no tumor recurrence occurred. After Cyber-knifetreatment, tumor size remained stable in 1 patient anddecreased in 2 patients.In case of incidental meningioma, the location, size,radiological aspect, age, and the multiplicity of thelesions must be considered. The radiological characte-ristics associated with low tumoral growth rate are theexistence of calcifications and hypointense regions onT2-weighted MR images. On the radiological aspect,more than 60% of asymptomatic meningiomas will notgrow in size. However, some meningiomas, even smallin size, must be treated because of their location or therisk of producing neurological deficits, expecially inyoung patients.

Incidental intracranial meningiomas:our experience in the last 8 years

ALAFACI, Concetta;LA FATA, GIUSEPPE;GRANATA, Francesca;
2012

Abstract

Introduction.The increased use of magnetic resonan-ce and computed tomography imaging has facilitatedthe diagnosis of brain tumours even before the patientsshow clinical symptoms and signs. A significant amountof incidental lesions identified are meningiomas. Thenatural history of incidental intracranial meningiomas mustbe known in order to develop the optimal therapeuticstrategy: what is the tumor growth rate? How many asymp-tomatic tumours eventually become symptomatic?Object. The aim of this study was to report our expe-rience of incidental asymptomatic intracranial menin-giomas and the different adopted treatment modali-ties, such as conservative treatment, microsurgery (MS)and Cyber-Knife radiosurgery.Materials and Methods. We searched retrospectivelyall patients with intracranial meningiomas treated inour Department in the last 8 years. Between January2004 and May 2012, 188 patients with intracranial me-ningiomas were examined. Among those patients, 24cases (12,8%) presented an incidental meningioma. Thisgroup was made up of 17 females (71%) and 7 males(29%), with a mean age of 67 years. The incidentalfinding was consequent to head trauma in 16 cases,endocrinal disorders in 3 cases, acute cerebrovasculardisease in 3 cases, typical trigeminal neuralgia with aneurovascular conflict in 1 case, and senile dementia in1 patient. Treatment modalities were essentially micro-surgical removal of the tumour, Cyber-Knife radiosur-gery and clinical observation.Results and conclusions. In our series, 12 patientsunderwent surgical treatment (6 females and 6 males,mean age of 65 years), 3 patients were treated withCyber-knife radiosurgery (all females, mean age of 66years), while 9 patients (8 females and 1 male, mean ageof 70 years) were clinically monitored. Surgical treatedpatients did not have any permanent neurologic defici-ts and no tumor recurrence occurred. After Cyber-knifetreatment, tumor size remained stable in 1 patient anddecreased in 2 patients.In case of incidental meningioma, the location, size,radiological aspect, age, and the multiplicity of thelesions must be considered. The radiological characte-ristics associated with low tumoral growth rate are theexistence of calcifications and hypointense regions onT2-weighted MR images. On the radiological aspect,more than 60% of asymptomatic meningiomas will notgrow in size. However, some meningiomas, even smallin size, must be treated because of their location or therisk of producing neurological deficits, expecially inyoung patients.
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Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/11570/2335443
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