Abstract
Purpose: Meningiomas are the most common primary intracranial neoplasms and clinical symptom appearance depends on their volume and location. This study aimed to identify factors that influence clinical symptoms and to determine a specific threshold tumor volume for the prediction of symptomatic progression in patients with convexity, parasagittal, and falx meningiomas.Materials and Methods: We retrospectively studied patients with radiologically suspected convexity, parasagittal, or falx meningiomas at our institution.Results: The data of three hundred thirty-three patients were analyzed. We further divided patients into two groups based on clinical symptoms: an asymptomatic group (250 cases) and a symptomatic group (83 cases). Univariate analysis revealed significant differences between the groups in terms of sex (p = 0.002), age at the time of volumetric analysis (p < 0.001), hyperintense lesions on T2-weighted images (p = 0.029), peritumoral edema (p < 0.001), maximum tumor diameter (p < 0.001), and tumor volume (p < 0.001). Further multivariate analysis revealed significant differences between the groups in terms of age at the time of volumetric analysis (p = 0.002), peritumoral edema (p < 0.001), and tumor volume (p < 0.001). The receiver operating characteristic curve revealed a threshold tumor volume of 21.1 ml for predicting whether a patient would develop symptoms (sensitivity 0.843, specificity 0.880, an area under the curve 0.919 [95% confidence interval: 0.887–0.951]).Conclusion: We identified factors predictive of clinical symptoms in patients with convexity, parasagittal, and falx meningiomas and determined the first-ever threshold tumor volume for predicting symptomatic progression in such patients.
Highlights
Meningiomas are the most common primary intracranial tumors, accounting for ∼25–38% of all such lesions [1, 2]
We excluded patients diagnosed with neurofibromatosis, those for whom magnetic resonance imaging (MRI) Digital Imaging and Communications in Medicine (DICOM) data were not available, and those whose symptoms were unknown due to insufficient medical records of their first visit
When patients had more than one convexity, parasagittal, or falx meningioma, we selected the largest one for analysis
Summary
Meningiomas are the most common primary intracranial tumors, accounting for ∼25–38% of all such lesions [1, 2]. In one study in which the median tumor volume was 35.7 ml (range 1.1–133.1 ml) and 90% (52 patients) were symptomatic, tumor volume was statistically significantly related to the appearance of clinical symptoms [6]. In recent meta-analyses, 4.7–8.1% of patients with incidentally discovered intracranial meningiomas developed related symptoms at followup visits [11, 12]. The specific locations of the tumors were not examined in either report The location of such a tumor is important as it is related to the symptoms a patient will experience [8], as well as the clinical and biological behavior of the tumor [6, 13, 14]
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