Natural history of spheno-orbital meningiomas

Acta Neurochir (Wien). 2011 Feb;153(2):395-402. doi: 10.1007/s00701-010-0878-0. Epub 2010 Dec 1.


Background: To investigate the natural history and the growth rate of spheno-orbital meningiomas (SOMs).

Methods: Ninety patients with a diagnosis of SOM were included, and patient charts and imaging were evaluated. In a subset of 32 patients, volumetric studies were performed.

Results: The median follow-up for the entire group was 4 years (range, 1-15); the mean age was 47.8 (range, 26-93) years; 94% of the patients were female. The most common clinical signs and symptoms were proptosis (93%), visual deterioration (65%), retro-bulbar pain (23%) and diplopia (6%). In 35% of patients in this series, no visual deterioration occurred, and in 30% only mild proptosis was present. The median annual growth rate of the SOMs in the subset of 32 patients was 0.3 cm³/year (range, 0.03-1.8 cm³/year). We assessed a trend for more rapid tumour growth in younger patients and found the initial volume of the tumour (rho = 0.63) and of the soft tissue component (rho = 074) to be significantly related to the growth rate.

Conclusion: SOMs are slow-growing tumours that cause primarily proptosis and visual deterioration. In a significant number of patients, these tumours cause minimal discomfort and symptomatology. Therefore, in the absence of risk factors, we advocate a "wait and see" policy. For patients with large SOMs or with a large soft tissue component at first visit or with fast growing SOMs (>1cm³/year), a follow-up examination every 6 months is indicated.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Meningeal Neoplasms / complications
  • Meningeal Neoplasms / diagnosis
  • Meningeal Neoplasms / pathology*
  • Meningioma / complications
  • Meningioma / diagnosis
  • Meningioma / pathology*
  • Middle Aged
  • Orbital Neoplasms / complications
  • Orbital Neoplasms / diagnosis
  • Orbital Neoplasms / pathology*
  • Skull Base Neoplasms / complications
  • Skull Base Neoplasms / diagnosis
  • Skull Base Neoplasms / pathology