Natural history of elderly patients with asymptomatic meningiomas

Objective-For the treatment of elderly patients with asymptomatic meningiom as, it is important to determine their natural history. Based on results of follow up examinations, the natural history of such patients was clarified and prognostic factors concerning the potential of tumour growth in the ag ed were identified. Methods-The clinical records and imaging studies of 40 elderly (over 70 yea rs) patients with asymptomatic meningiomas were analysed. The patients were followed up with repeated imaging studies, and changes in tumour size, cli nical signs, and outcomes were evaluated, Results-There were 32 women and eight men with a mean age of 76.1 years. Th e mean follow up period was 38.4 months, ranging from 6 to 97 months. Six p atients died during the follow up period from disorders other than the tumo urs, and one patient died as a result of the tumour. Twenty six patients (m ean follow up period 41.8 months, range 10-97 months) showed no tumour grow th. Fourteen patients showed tumour growth (mean follow up period 32.1 mont hs, range 6-88 months). Five (four men and one woman) of these patients bec ame symptomatic, Based on imaging analysis (1) calcification of the tumour was associated with no tumour growth (p=0.036), and (2) the tumour size at the initial diagnosis was related to subsequent tumour growth (p=0.016). Ot her possible factors related to tumour growth included sex and hyperintensi ty on MRI T2 weighted images. Conclusion-In elderly patients with asymptomatic meningiomas, careful clini cal follow up with imaging studies is important. The imaging features menti oned may contribute to prediction of tumour growth.