SUPRASELLAR MENINGIOMA - STILL TOO OFTEN DIAGNOSED TOO LATE

Background and objective: Suprasellar meningioma continues to be diagn osed very late after the onset of first eye symptoms. This study was a imed at demonstrating the effect of delay on the long-term visual loss . Patients and methods: In the course of a retrospective study all 53 consecutive patients operated on for suprasellar meningioma from 1982 to 1991 were contacted (47 women, 6 men; average age 49.5 years) 46 of the 49 surviving consented to the follow-up investigation. The extent of preoperative visual loss, tumour size, presence of optic nerve atr ophy and duration of visual loss, data that provide an indirect measur e of how soon the correct diagnosis was made, were analysed with regar d to their effect on long-term ophthalmological results. Results: The mean period elapsing from onset of first visual symptoms to the defini tive diagnosis of suprasellar meningioma was 22.3 months. The data sho wed that the long-term results were the worse the later the diagnosis was made. Conclusions: The commonly very late diagnosis of suprasellar meningioma as cause of visual loss is an international problem and is presumably due to the low incidence of the tumour (1-2 cases per 1 mi ll. population per year). If long-term results are to be improved, pri mary care doctors must be made aware of the differential diagnosis of visual loss caused by pressure from a tumour.