The Natural History of Petroclival Meningiomas: A Volumetric Study. Issue 1 (January 2017)

• Record Type: Journal Article
• Authors: Hunter, Jacob B.; Yawn, Robert J.; Wang, Ray; O'Connell, Brendan P.; Carlson, Matthew L.; Mistry, Akshitkumar; Haynes, David S.; Thompson, Reid C.; Weaver, Kyle D.; Wanna, George B.
• Is Part Of: Otology & neurotology. Volume 38:Issue 1(2017)
• Page Start: 123
• Page End: 128
• Publication Date: 2017-01
• Subjects: Meningioma -- Natural history -- Petroclival meningioma -- Skull base -- Volumetric growth; Otology -- Periodicals; Ear -- Diseases -- Periodicals; Skull base -- Surgery -- Periodicals; 617.8005
• DOI: 10.1097/MAO.0000000000001260
• Languages: English
• ISSNs: 1531-7129

Abstract

Abstract : Objectives: This study characterizes primary petroclival meningioma growth rates, before intervention, using volumetric analysis. In addition, predictors of growth are analyzed. Methods: 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. Results: 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 3 (range, 0.1–25.8 cm 3 ) 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 3 /yr (−0.63 to 25.9 cm 3 /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. Conclusion: 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 3 /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.